A new review of evidence suggests that a “stepped-up” care approach can lower blood pressure for patients who haven’t achieved good control of their hypertension.

Stepped-up high blood pressure care means a physician has mapped out a clear plan to adjust hypertension treatment — and blood pressure-lowering medication — when a patient’s health goals are not met.

 

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care.

Fahey is a family physician with the Tayside Centre for General Practice in Dundee, Scotland, and a hypertension researcher.

“The Hypertension Detection and Follow-up trial showed that if you improve the intermediate outcome of improving high blood pressure then the prevention of strokes and heart attacks does occur,” Fahey said.

A stepped-up approach reorganizes the way health care is delivered, allowing physicians to keep tighter tabs on their patients with hypertension.

In the United Kingdom, that typically means patients taking antihypertension medication are enrolled in a registry of people who will receive intensified monitoring and follow-up care.

“I always say to patients, ‘If you are going to start taking these drugs you might as well try to accrue the benefits that we know we can give you,” Fahey said.

Fahey said having a dedicated, systematic hypertension-care plan in place may help doctors avoid delays in responding to patients who are not improving.

“With high blood pressure, doctors think, ‘Well, I’ll measure it in a month’s time,’ which is just deferring what should be proper clinical practice,” Fahey said.

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