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Role of community programs in controlling blood pressure

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Abstract

Despite more than 30 years of intense activity to improve control—and more recently prevention—high blood pressure continues to be a major public health problem. Evidence-based reviews have identified best practices and quality improvement strategies to address prevention and control. Since the 1970s, community-based programs have been instrumental in raising awareness, increasing knowledge, and promoting changes in health behavior to improve blood pressure control. Most of these programs have emphasized the use of partnerships and involvement of community residents in conducting screening and referral activities, implementing clinical practice guidelines, and increasing healthy eating and physical activity. Many also have used health care team approaches, including the use of trained community health workers to deliver targeted, culturally sensitive heart health education, particularly related to the prevention of cardiovascular disease risk factors in general and high blood pressure in particular. Increased focus on implementation of evidence-based lifestyle and clinical management strategies coupled with community-based approaches may help increase blood pressure control rates within communities.

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References and Recommended Reading

  1. Fields LE, Burt VL, Cutler JA, et al.: The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension 2004, 44:398–404.

    Article  PubMed  CAS  Google Scholar 

  2. Vasan RS, Beiser A, Seshadri S, et al.: Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA 2002, 287:1003–1010.

    Article  PubMed  Google Scholar 

  3. Wang TJ, Casan RS. Epidemiology of uncontrolled hypertension in the United States. Circulation 2005, 112:1651–1662.

    Article  PubMed  Google Scholar 

  4. National Heart, Lung, and Blood Institute Morbidity and Mortality Chartbook, 2004.

  5. CDC. Racial/Ethnic Disparities in prevalence, treatment and control of hypertension, United States. Morbidity and Mortality Weekly Report 1999-2002, 54:7–9.

    Google Scholar 

  6. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). NIH Pub. No. 04-5230. Bethesda, MD: National Heart, Lung, and Blood Institute, 2004; 86 pages. This important report updates the sixth report and provides an evidence-based clinical and lifestyle approaches to prevent and control hypertension.

  7. Antihypertensive and lipid-lowering treatment to prevent heart attack trial collaborative research group. Diuretic versus alpha-blocker as first-step antihypertensive therapy: final results from the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). Hypertension 2003, 42:239–246.

  8. Conlin PR, Chow D, Miller ER, et al.: The effect of dietary patterns on blood pressure control in hypertensive patients: results from the dietary approaches to stop hypertension (DASH) trial. Am J Hypertens 2000, 13:949–955.

    Article  PubMed  CAS  Google Scholar 

  9. Svetkey LP, Simons-Morton DG, Proschan MA, et al.: Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control. J Clin Hypertens (Greenwich) 2004, 6:381–382.

    Google Scholar 

  10. Welch VLL, Hill MN: Effective strategies for blood pressure control. Cardiol Clin 2002, 20:321–333.

    Article  PubMed  Google Scholar 

  11. Winkleby MA, Feldman HA, Murray DM: Joint analysis of three U.S. community intervention trials for reduction of cardiovascular disease risk. J Clin Epidemiol 1997, 50:645–58.

    Article  PubMed  CAS  Google Scholar 

  12. Mittelmark MB, Hunt MK, Heath GW, Schmid TL: Realistic outcomes: lessons from community-based research and demonstration programs for the prevention of cardiovascular diseases. J Public Health Policy 1993, 14:437–462.

    Article  PubMed  CAS  Google Scholar 

  13. Kong BW: Community-based hypertension control programs that work. J Health Care Poor Underserved 1997, 8:409–15.

    PubMed  CAS  Google Scholar 

  14. Shellman J. Promoting elder wellness through a community -based blood pressure clinic. Public Health Nursing 2000, 17:257–263.

    Article  PubMed  CAS  Google Scholar 

  15. Nine SL, Lakies CL, Jarrett HK, Davis BA: Community-based chronic disease management program for African Americans. Outcomes Management 2003, 7:106–111.

    PubMed  Google Scholar 

  16. Campbell NR, Jeffery P, Kiss K, et al.: Building capacity for awareness and risk factor identification in the community: the blood pressure assessment program of the Calgary Fire Department. Can J Cardiol 2000, 17:1275–1279.

    Google Scholar 

  17. McManus RJ, Mant J: Community pharmacies for detection and control of hypertension. J Hum Hypertens 2001, 15:509–510.

    Article  PubMed  CAS  Google Scholar 

  18. Egan BM, Lackland DT: Strategies for cardiovascular disease prevention: importance of public and community health programs. Ethn. Dis 1998, 8:228–239.

    PubMed  CAS  Google Scholar 

  19. Bansal N, Tendler BE, White WB, Mansoor GA: Blood pressure control in the hypertension clinic. Am.J Hypertens 2003, 16:878–880.

    Article  PubMed  Google Scholar 

  20. Norby SM, Stroebel RJ, Canzanello VJ: Physician-nurse team approaches to improve blood pressure control. J Clin Hypertens.(Greenwich) 2003, 5:386–392.

    Article  Google Scholar 

  21. Gabbay RA., Lendel I, Saleem TM, et al.: Nurse case management improves blood pressure, emotional distress and diabetes complication screening. Diabetes Res Clin Pract 2006, 71:28–35.

    Article  PubMed  Google Scholar 

  22. Earle KA, Taylor P, Wyatt S, et al.: A physician-pharmacist model for the surveillance of blood pressure in the community: a feasibility study. J Hum Hypertens 2001, 15:529–533.

    Article  PubMed  CAS  Google Scholar 

  23. Stroebel RJ, Broers JK, Houle SK, et al.: Improving hypertension control: a team approach in a primary care setting. Jt Comm J Qual Improv 2000, 26:623–632.

    PubMed  CAS  Google Scholar 

  24. Wagner EH, Austin BT, Davis C, et al.: Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001, 20:64–78.

    Article  CAS  Google Scholar 

  25. Brownstein JN, Bone LR, Dennison CR, et al.: Community health workers as interventionists in the prevention and control of heart disease and stroke. Am J Prev Med 2005, 29:128–133 This paper highlights the importance and benefits of using CHWs in improving chronic disease care and health outcomes, particularly in the area of hypertension.

    Article  PubMed  Google Scholar 

  26. Snedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: Institute of Medicine, National Academies Press, 2002. Available at: www.nap.edu/books/ 030908265X/html. Accessed April 20, 2006. This Institute of Medicine report stems from a study commissioned by Congress to examine health disparities (quality and services) experienced by racial and ethnic minorities. Many recommendations to eliminate disparities were cited, including the use of CHWs as a strategy.

    Google Scholar 

  27. Gary TL, Batts-Turner M, Bone LR, et al.: A randomized controlled trial of the effects of nurse case manager and community health worker team interventions in urban African-Americans with type 2 diabetes. Control Clin Trials 2004, 25:53–66.

    Article  PubMed  Google Scholar 

  28. Krieger J, Collier C, Song L, Martin D: Linking community -based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers. Am J Public Health 1999, 89:856–861.

    Article  PubMed  CAS  Google Scholar 

  29. Hill MN, Becker DM: Roles of nurses and health workers in cardiovascular health promotion. Am J Med Sci 1995, 310:S123-S126.

    Article  PubMed  Google Scholar 

  30. Fahey T, Schroeder K, Ebrahim S: Interventions to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev 2006 Apr 19 (2): CD005182. Review.

  31. Schroeder K, Fahey T, Ebrahim S: Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev 2005 Jan 25 (2):CD005182.

  32. Walsh J, McDonald KM, Shojania KG, et al.: Closing the quality gap: A critical analysis of quality improvement strategies. Hypertension Care, 2005. Vol. 3 of: Shojania KG, McDonald KM, Wachter RM, Owens DK, editors. Technical Review 9. (Prepared by the Stanford University -UCSF Evidence-based Practice Center, under Contract No. 290-02-0017). AHRQ Publication No. 04-0051-3. Rockville, MD: Agency for Healthcare Research and Quality.

    Google Scholar 

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Authors and Affiliations

  1. Office of Prevention, Education, and Control, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 31, Room 4A10, 31 Center Drive, MSC 2480, 20892-2480, Bethesda, MD, USA

    Robinson Fulwood PhD, MSPH

Authors
  1. Robinson Fulwood PhD, MSPH
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  2. Jeanette Guyton-Krishnan PhD, MS
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  3. Madeleine Wallace PhD
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  4. Ellen Sommer MBA
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Correspondence to Robinson Fulwood PhD, MSPH.

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Fulwood, R., Guyton-Krishnan, J., Wallace, M. et al. Role of community programs in controlling blood pressure. Current Science Inc 8, 512–520 (2006). https://doi.org/10.1007/s11906-006-0031-x

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  • DOI: https://doi.org/10.1007/s11906-006-0031-x

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