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J Am Coll Cardiol. 2018 Sep 11;72(11):1278-1293. doi: 10.1016/j.jacc.2018.07.008.

Prevention and Control of Hypertension: JACC Health Promotion Series.

Author information

1
Department of Medicine, University of Virginia, Charlottesville, Virginia. Electronic address: rmc4c@virginia.edu.
2
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
3
Departments of Population Health Sciences, Medicine, Psychiatry and Behavioral Sciences and School of Nursing, Duke University, Durham, North Carolina. Electronic address: https://twitter.com/HaydenBosworth.
4
Department of Epidemiology, Tulane University, New Orleans, Louisiana.

Abstract

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.

KEYWORDS:

antihypertensive agents; dietary sodium; exercise; lifestyle; medication adherence; telemedicine

PMID:
30190007
DOI:
10.1016/j.jacc.2018.07.008

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