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– Improving rates of hypertension control reduces patients’ health risks –

 

CINCINNATI – Feb. 21, 2024 – Often called the “silent killer” because it often shows no symptoms, hypertension affects almost half of adults (about 48% or almost 120 million) in the United States, according to the Centers for Disease Control and Prevention (CDC). And most of those adults do not have their hypertension under control.
 
In 2021, the Cincinnati Health Department (CHD) launched a Quality Improvement (QI) Project, a blood pressure control initiative that aimed to increase the percentage of patients aged 18-85 with controlled hypertension from a median of 58% to 72% across four CHD health centers during a 3-year period.
 
The aim of the project was to enhance the health of CHD’s patients to be able to live at their highest quality of life by reducing their risk of serious cardiovascular morbidity and mortality with improved blood pressure control.
 
“While prevalent among adults in the United States, including Cincinnati, hypertension can be controlled with lifestyle changes and – if necessary – appropriate medication,” said Meron Hirpa, M.D., public health physician with the Cincinnati Health Department, who leads the project. “However, to manage hypertension, patients must know what their blood pressure is and how to control it. And that was the goal of our project.”
 
At the end of 2023, three years after the project was started, hypertension control across patients at four CHD health centers increased from 58% to 74%, which is 2% higher than the goal of 72%. These results led it to earn Gold+ level national recognition from the American Heart Association and American Medical Association.
 
“The results of this project are remarkable,” said Grant Mussman, M.D., MHSA, Cincinnati Health Department Commissioner. “This is an example of what we can do to improve health outcomes in Cincinnati. By identifying specific health issues that negatively impact our community and coming up with appropriate Quality Improvement measures, we can make a difference.”
 
Here are some key facts about hypertension (high blood pressure), according to the CDC (https://www.cdc.gov/bloodpressure/facts.htm).
 
  • Having hypertension puts people at risk for heart disease and stroke, which are leading causes of death in the United States.
  • In 2021, hypertension was a primary or contributing cause of 691,095 deaths in the United States.
  • Nearly half of adults have hypertension (48.1%, 119.9 million), defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension.
  • About 1 in 4 adults with hypertension have their hypertension under control (22.5%, 27 million).
 
Still according to the CDC, certain groups of people are more likely to have control over their high blood pressure than others.
 
  • A greater percentage of men (50%) have high blood pressure than women (44%).
  • High blood pressure is more common in non-Hispanic Black adults (56%) than in non-Hispanic white adults (48%), non-Hispanic Asian adults (46%), or Hispanic adults (39%).
  • Among those recommended to take blood pressure medication, blood pressure control is higher among non-Hispanic white adults (32%) than in non-Hispanic Black adults (25%), non-Hispanic Asian adults (19%), or Hispanic adults (25%).
This QI project is part of CHD’s focus on increasing health in Cincinnati by identifying health issues that impact life expectancy disparities. To elevate life expectancy, CHD identifies preventable causes of death, such as hypertension, that disproportionately affect certain populations and neighborhoods. CHD has specifically promoted access to care and provided resources over the last two years, such as free blood pressure cuffs, which have increased hypertension control by almost 10% among Black patients. While this QI work is ongoing, CHD is also preparing to bring some of its services to trusted local community partners.