Helping Patients Manage High Blood Pressure

Keeping blood pressure under control is one of the most effective strategies to prevent heart disease. For people with high blood pressure (hypertension), the heart has to work harder to keep up the increased pressure in the blood vessels. This puts a strain on the heart in the long run and contributes to coronary heart disease, heart attacks, and heart failure.

In 2014, the MaineHealth Accountable Care Organization (MaineHealth ACO) implemented a performance feedback system for practices that treat patients with hypertension.

• Patients diagnosed with hypertension were identified and each month the percentage of these patients whose hypertension was under control at their last visit was reported back to clinical teams.
• In addition to their team performance, rates for patients grouped by geographic region were included in the feedback reports as comparisons.
• Practices implemented strategies to help meet targets and were provided with clinical improvement support.

This systemwide model of data feedback, clinical improvement support and implementation of practice-level strategies has resulted in steady improvements in the percentage of patients who have their blood pressure appropriately managed.

Among the almost 50,000 patients diagnosed with hypertension that are treated within our primary care practices, the percentage whose blood pressure was under control (≥140/90 mmHg) increased from 66% in January 2014 to 75% in November 2018, surpassing the target goal of 72%. This goal is continuously assessed and updated over time.

New Guideline for High Blood Pressure

The American College of Cardiology and the American Heart Association recently released a new guideline for the detection, prevention, management and treatment of high blood pressure.

The new guideline lowers the definition of high blood pressure to 130/80mm Hg rather than 140/90mm Hg to account for complications that can occur at lower numbers and allow for earlier lifestyle and medication interventions.

MaineHealth supports the change in guidelines and will be updating relevant blood pressure trainings, patient education and clinical tools to reflect the definition of hypertension.