High blood pressure was listed as a primary or contributing cause of death for approximately 336,000 Americans in 2007. If all patients with high blood pressure were treated to goal as outlined in current clinical guidelines, it is estimated that 46,000 deaths might be averted each year. Total annual costs associated with hypertension are $156 billion, including medical costs of $131 billion and lost productivity costs of $25 billion.

The Task Force on Community Preventive Services recommends team-based care (TBC) to improve blood pressure (BP) control. The recommendation follows evidence from a 77-studies review, which shows that TBC raised the number of patients with controlled blood pressure, resulting in lower systolic and diastolic blood pressure, as well as in better outcomes in diabetic patients and those with high blood lipids.

The review demonstrates that patients who receive care from a team of health professionals, such as a primary care provider supported by a pharmacist, nurse, dietitian, social worker, or community health worker instead of by a single physician, had improved blood pressure control.

The primary care provider received assistance from team members, who provided support and shared the primary carer’s responsibility in providing hypertension care. The team assisted in the patient’s medication management, patient follow-up, and assisting the patient in sticking to their BP control plan, which included routine BP monitoring, taking medications as prescribed, consuming less sodium and increasing their physical activity.

The biggest improvements in BP were observed when team members were able to change medication independently, or with approval of the primary care provider, as compared with small improvements when team members were only allowed to oversee the taking of medication. A complete review of the findings is expected for release in May 2013.

Thomas R. Frieden, M.D., M.P.H., director at the Centers for Disease Control and Prevention, commented:

“Adoption of this model throughout the United States would improve blood pressure control for the 68 million adult Americans who have high blood pressure and reduce their risk of heart attack, stroke, and other health problems. This analysis shows that when primary care physicians and other health care professionals with different expertise and approaches work together to support their patients, they can find the right formula for getting blood pressure under control.”

The Million Hearts initiative, a national, public-private initiative to prevent 1 million heart attacks and strokes by 2017 was launched in September 2011 by the Department of Health and Human Services and is entirely based upon team-based care. To achieve its goal, the initiative targets four key health behaviors, including blood pressure control, appropriate aspirin consumption, the management of cholesterol and smoking cessation.

The Million Hearts initiative works inline with the Healthy People 2020 goal to decrease the number of people in the U.S. suffering from high blood pressure. The team-based care is a model based on evidence. It is a collaboration between various contributing team members, providers and patients to encourage healthy behaviors and proper use of medications with regard to cardiovascular risk factors, including high blood pressure.

Written By Petra Rattue