Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled.

A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines.

The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON PUBLIC HEALTH PRIORITIES TO REDUCE AND CONTROL HYPERTENSION IN THE U.S. POPULATION
• Reviewers
• Acknowledgements
• Summary
• 1. Introduction
  • CDC EFFORTS TO REDUCE AND CONTROL HYPERTENSION
  • STUDY PROCESS
  • STUDY APPROACH
  • REFERENCES
• 2. Public Health Importance of Hypertension
  • PREVALENCE OF HYPERTENSION IN THE U.S. POPULATION
  • INTERNATIONAL COMPARISON
  • AWARENESS, TREATMENT, AND CONTROL OF HYPERTENSION IN THE COMMUNITY
  • HYPERTENSION DATA QUALITY AND MONITORING CONCERNS
  • TRENDS IN ASSOCIATED RISK FACTORS
  • RECOMMENDATIONS
  • REFERENCES
• 3. The Role of the Division for Heart Desease and Stroke Prevention in the Prevention and Control of Hypertension
  • PROGRAMMATIC FUNDING
  • NATIONAL HEART DISEASE AND STROKE PREVENTION PROGRAM
  • WISEWOMAN (WELL-INTEGRATED SCREENING AND EVALUATION FOR WOMEN ACROSS THE NATION)
  • THE PAUL COVERDELL NATIONAL ACUTE STROKE REGISTRY
  • STATE CARDIOVASCULAR HEALTH EXAMINATION SURVEY
  • ACTIVITIES TO REDUCE SODIUM INTAKE
  • OTHER PROGRAMMATIC ACTIVITIES
  • DIVISION FOR HEART DISEASE AND STROKE PREVENTION STRATEGIC PLAN
  • DHDSP COLLABORATION WITH OTHER CDC UNITS
  • REFERENCES
• 4. Interventions Directed at the General Population
  • METHODOLOGY
  • PROMOTE WEIGHT LOSS AMONG OVERWEIGHT PERSONS
  • DECREASE SODIUM INTAKE
  • INCREASE POTASSIUM AND INTAKE OF FRUITS AND VEGETABLES
  • CONSUME A HEALTHY DIET
  • REDUCE EXCESSIVE ALCOHOL INTAKE
  • INCREASE PHYSICAL ACTIVITY
  • MULTIPLE DIETARY INTERVENTIONS
  • OTHER POTENTIAL INTERVENTIONS
  • COMMUNITY AND ENVIRONMENTAL INTERVENTIONS
  • RELATIVE COSTS OF POPULATION-BASED INTERVENTIONS
  • POPULATION-BASED INTERVENTIONS AND HEALTH DISPARITIES
  • CONCLUSIONS
  • REFERENCES
• 5. Interventions Directed at Individuals with Hypertension
  • ACCESS TO CARE AND CONTROL OF HYPERTENSION
  • EMPLOYER INITIATIVES TO ADDRESS HYPERTENSION
  • COMMUNITY HEALTH WORKERS AND HYPERTENSION
  • CONCLUSIONS
  • REFERENCES
• 6. Implementing a Population-Based Policy and Systems Approach to the Prevention and Control of Hypertension
  • RECOMMENDATIONS FOR STATE AND LOCAL HEALTH JURISDICTIONS
  • RESOURCES FOR HYPERTENSION PREVENTION AND CONTROL
  • ENSURING SYSTEM ACCOUNTABILITY
  • HYPERTENSION AS A SENTINEL FOR SUCCESS OF THE PUBLIC HEALTH SYSTEM IN REDUCING HEALTH DISPARITIES
  • REFERENCES
• A Committee Member Biographies
• B Agendas of Public Meetings Held by the Committee on Public Health Priorities to Reduce and Control Hypertension
• C A Public Health Action Plan Prevent Heart Disease and Stroke
• D DHDSP Strategic Plan

This study was supported by Contract No. 200-2005-13434, TO 18 between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2010. A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.