Author + information
- Received May 17, 2018
- Revision received June 26, 2018
- Accepted July 2, 2018
- Published online September 3, 2018.
- Robert M. Carey, MDa,∗ (, )@uvahealthnews@UABNews,
- Paul Muntner, PhDb,
- Hayden B. Bosworth, PhDc@HaydenBosworth and
- Paul K. Whelton, MB, MD, MScd
- aDepartment of Medicine, University of Virginia, Charlottesville, Virginia
- bDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
- cDepartments of Population Health Sciences, Medicine, Psychiatry and Behavioral Sciences and School of Nursing, Duke University, Durham, North Carolina
- dDepartment of Epidemiology, Tulane University, New Orleans, Louisiana
- ↵∗Address for correspondence:
Dr. Robert M. Carey, P.O. Box 801414, University of Virginia Health System, Charlottesville, Virginia 22908-1414.
Hypertension, the leading risk factor for cardiovascular disease, originates from combined genetic, environmental, and social determinants. Environmental factors include overweight/obesity, unhealthy diet, excessive dietary sodium, inadequate dietary potassium, insufficient physical activity, and consumption of alcohol. Prevention and control of hypertension can be achieved through targeted and/or population-based strategies. For control of hypertension, the targeted strategy involves interventions to increase awareness, treatment, and control in individuals. Corresponding population-based strategies involve interventions designed to achieve a small reduction in blood pressure (BP) in the entire population. Having a usual source of care, optimizing adherence, and minimizing therapeutic inertia are associated with higher rates of BP control. The Chronic Care Model, a collaborative partnership among the patient, provider, and health system, incorporates a multilevel approach for control of hypertension. Optimizing the prevention, recognition, and care of hypertension requires a paradigm shift to team-based care and the use of strategies known to control BP.
Dr. Carey has received grant support from the National Heart, Lung, and Blood Institute (R01-HL-128189 and P01-HL-074940). Dr. Muntner has received grant support from the American Heart Association (15SFRN2390002). Dr. Bosworth has received grant funding from the Veterans Affairs Health Services Research and Development (VAHSR&D 08-027), the National Institutes of Health (NIH K12-HL-138030, R01-DK093938, and R34-DK-102166), Johnson & Johnson, Otsuka Pharmaceuticals, Sanofi, and Improved Patient Outcomes; and has served as a consultant for Sanofi and Otsuka Pharmaceuticals. Dr. Whelton has received grant support from the National Institute of General Medical Sciences (P20GM109036).
- Received May 17, 2018.
- Revision received June 26, 2018.
- Accepted July 2, 2018.
- 2018 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.