Blood pressure management techniques -
National Association of Chronic Disease Directors: Multistate EHR-based Network for Disease Surveillance. Federal Employees Health Benefits Program: Plan Performance Assessment — High Priority Measures [PDF — KB].
Patient-Centered Outcomes Research Institute PCORI : PCORI, NIH Partnership to Fund Research Asking How to Reduce Hypertension Disparities. As a state or local government agency or representative, you can play an important role in protecting and improving the health of your residents. You can support efforts to improve high blood pressure control across the country by working with multiple sectors.
You can work with clinical and public health partners to focus on population groups with the greatest need. You can also help build diverse public and private partnerships to coordinate the efforts of multiple groups, prevent duplication of efforts, and use resources efficiently.
Million Hearts ® : Hypertension Control Champions. As a public health professional, you and the organizations you work for are in a unique position to help improve high blood pressure control. You can help bring together partners from multiple sectors to address this public health problem at federal, state, and local levels.
Million Hearts ® : Hypertension Control Change Package [PDF — 1. As a health care professional, you see many patients with high blood pressure who do not have this condition under control. You can help improve high blood pressure control in the United States by identifying populations at highest risk and highlighting needed resources.
You can also share your firsthand knowledge about the problems associated with uncontrolled high blood pressure. Commit to following the most current clinical guidelines for high blood pressure control to ensure that your care is cost-effective, evidence based, and focused on achieving control across all populations.
Target: BP: CME Course: Using SMBP to Diagnose and Manage HBP. Members of public health and health care professional associations and societies can help improve blood pressure control by changing policies, systems, and environments that make it hard for people to control their high blood pressure.
As a professional association or society, you can play a key role in calling attention to the problems associated with uncontrolled high blood pressure, including negative health outcomes and disparities in certain populations. You can also share information, provide training, and mobilize your members to support policy changes.
Target: BP: How to Measure Your Blood Pressure at Home. American Heart Association: Hypertension Guideline Resources. To help improve high blood pressure control in the United States, health care practices, health centers, and health systems can deliver patient care services in ways that have been proven to work.
You can use multidisciplinary care teams to ensure comprehensive care and use protocols to standardize patient care. You can also use high-quality data to track and encourage high performance among your health care professionals.
Target: BP: In-Office Measuring Blood Pressure Infographic. For insurance companies, there are short-term costs associated with treatments and interventions designed to improve high blood pressure control among their beneficiaries.
Examples of treatments and interventions include antihypertensive medications, home blood pressure monitors, and approved lifestyle programs.
Treatments and interventions reduce the risk and costs associated with adverse cardiovascular outcomes over time. The costs associated with adverse cardiovascular outcomes include hospitalization for a heart attack, stroke, or heart failure, as well as care services related to cardiac rehabilitation or management of end-stage kidney disease.
Million Hearts ® : Cardiovascular Health Medication Adherence: Action Steps for Health Benefit Managers [PDF — KB].
American Medical Association: SMBP CPT ® Coding [PDF — KB]. For employers and individuals who purchase health plans, there are short-term costs associated with treatments and interventions designed to improve high blood pressure control.
Examples of treatment and interventions include antihypertensive medications, home blood pressure monitors, and approved lifestyle programs. These treatments and interventions reduce the risk and costs associated with adverse cardiovascular outcomes over time.
Costs also include costs associated with employees who are less productive or miss work because of illness. Million Hearts ® : Cardiovascular Health: Action Steps for Employers [PDF — KB]. Your university or school helps to train scientific and medical researchers who can expand our knowledge of what works to control high blood pressure.
More high blood pressure control research is needed to understand what interventions are most effective for a variety of populations and to identify the best way to implement them. Training programs in medicine, nursing, and pharmacy regularly integrate blood pressure assessment and related management into their curricula.
However, reinforcement of appropriate and effective activities is useful. Expanded training using a variety of research methods is likely needed, including quality improvement and population health management techniques.
A variety of partners, including health advocacy, minority-serving, and faith-based organizations, are needed to help make high blood pressure control a national priority. As a member of these organizations and partnerships, you can support funding at national, state, and local levels for policies and programs that have been proven to work.
You can also help ensure that scientific findings and resources are translated into actions that best serve your communities. Agency for Healthcare Research and Quality: Clinical-Community Linkages. Website addresses of nonfederal organizations are provided solely as a service to our readers.
Provision of an address does not constitute an endorsement by the U. Department of Health and Human Services HHS or the federal government, and none should be inferred. Skip directly to site content Skip directly to search. Español Other Languages. Minus Related Pages. Individuals Federal Government State and Local Governments Public Health Professionals Health Care Professionals Professional Associations and Societies Health Care Practices, Health Centers, and Health Systems Health Plans and Managed Care Organizations Employers and Health Plan Purchasers Academic Institutions and Researchers Community Organizations, Public—Private Partnerships, and Foundations.
How You Can Help If you have high blood pressure, take action to control it and improve your health. Work with your health care team to create a personal treatment plan with the goal of controlling your blood pressure. Follow your treatment plan and ask your health care team for help.
Be physically active and eat a healthy diet. Start by taking a daily walk and eating more fruits and vegetables. Make sure to take your medication as prescribed and let your health care team know if you have questions or concerns.
Learn to check your blood pressure at home by using a blood pressure monitor. Ask your health care team to teach you how to monitor your blood pressure and share your results. Selected Resources American College of Cardiology: CardioSmart High Blood Pressure Fact Sheet Target: BP: How to Measure Your Blood Pressure at Home Infographic How Do I Manage My Medicines?
Fact Sheet [PDF — KB] National Heart, Lung, and Blood Institute: DASH Eating Plan Centers for Disease Control and Prevention: Measure Your Blood Pressure Prevent and Manage High Blood Pressure Department of Health and Human Services: Move Your Way Department of Agriculture: Choose My Plate Million Hearts ® : Self-Measured Blood Pressure Monitoring.
Federal Government. How You Can Help The mission of the U. You can also support and help expand actions like the ones recommended here. Actions You Can Take Conduct research to test innovative interventions and models. Implement innovative interventions through current and emerging technology.
Recognize and reward clinicians, health centers, health systems, and health plans that routinely monitor and report success in high blood pressure control. Use funding to create policies that make high blood pressure control a priority in health care systems and communities.
Fund research to identify how to integrate proven strategies into clinical and community settings. Use research results to find ways to identify, expand, and share best practices. Expand public health insurance and public employee health plans to cover effective interventions and reduce costs.
Examples include Paying for automated home blood pressure monitors and community health worker services. Reducing copays for antihypertensive medications. Removing pre-authorization for treatments that improve overall cardiovascular health such as tobacco cessation and type 2 diabetes prevention programs.
Promote policies and principles of community design that increase physical activity for people of all abilities. Create activity-friendly routes to everyday destinations and improve transit systems. Increase access to healthy food and drink options.
Implement healthy food service guidelines in federal facilities and encourage their use in other settings. Support efforts to modernize data systems to improve high blood pressure control surveillance at the national, state, and local levels. Fund activities and strategies that address social determinants of health.
State and Local Governments. How You Can Help As a state or local government agency or representative, you can play an important role in protecting and improving the health of your residents. Actions You Can Take Fund activities and strategies that address social determinants of health.
Recognize and reward clinicians, health centers, health systems, payers, and communities that report success in high blood pressure control.
Share best practices and effective models with other partners. Enact policies that expand the scope of practice for pharmacists, community health workers, and nurses. Promote policies and principles of community design that increase physical activity for people of all abilities by creating activity-friendly routes to everyday destinations and improving transit systems.
Create or enhance access to public spaces for physical activity through shared use agreements. Support community programs that promote safe environments, such as crime reduction initiatives.
Implement healthy food service guidelines in public buildings. Selected Resources Million Hearts ® : Hypertension Control Champions Centers for Disease Control and Prevention: 6 18 Initiative: Accelerating Evidence into Practice, Control High Blood Pressure Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities [PDF — 3.
Public Health Professionals. How You Can Help As a public health professional, you and the organizations you work for are in a unique position to help improve high blood pressure control.
You can also share data to show what works and promote the use of effective strategies. Actions You Can Take Work with public health insurance programs and public employee health plans to cover effective interventions and reduce costs. Convene quality improvement collaboratives that help clinical teams and health systems achieve high levels of high blood pressure control.
Support food service guidelines that encourage more healthy food and drink options in state and local buildings, hospitals, worksites, and other community venues. Invest in evidence-based programs that link clinical services with community resources.
Help people make lifestyle changes and get access to food assistance programs. Conduct public health surveillance to identify groups and communities at highest risk of uncontrolled high blood pressure. Use data to monitor the effectiveness of your efforts to improve control. Selected Resources Million Hearts ® : Hypertension Control Change Package [PDF — 1.
Health Care Professionals. How You Can Help As a health care professional, you see many patients with high blood pressure who do not have this condition under control. Actions You Can Take Implement protocols to standardize patient care and empower all members of the clinical team to engage in patient management.
Refer all patients with high blood pressure to lifestyle change resources and ensure follow-up with patients after referrals.
When possible, prescribe to improve adherence by lowering patient costs, reducing access barriers, and simplifying regimens. Kjeldsen SE, Lund-Johansen P, Nilsson PM, Mancia G.
Unattended Blood Pressure Measurements in the Systolic Blood Pressure Intervention Trial: Implications for Entry and Achieved Blood Pressure Values Compared With Other Trials. Myers MG, Godwin M, Dawes M, Kiss A, Tobe SW, Kaczorowski J. Measurement of blood pressure in the office: recognizing the problem and proposing the solution.
Leung AA, Nerenberg K, Daskalopoulou SS, McBrien K, Zarnke KB, Dasgupta K, Cloutier L, Gelfer M, Lamarre-Cliche M, Milot A, et al. Hypertension Canada's Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.
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London: Arnold; Google Scholar. Kelly RP, Gibbs HH, O'Rourke MF, Daley JE, Mang K, Morgan JJ, Avolio AP. Nitroglycerin has more favourable effects on left ventricular afterload than apparent from measurement of pressure in a peripheral artery. Sharman JE, Marwick TH, Gilroy D, Otahal P, Abhayaratna WP, Stowasser M.
Randomized Trial of Guiding Hypertension Management Using Central Aortic Blood Pressure Compared With Best-Practice Care: Principal Findings of the BP GUIDE Study.
Cheng HM, Chuang SY, Sung SH, Yu WC, Pearson A, Lakatta EG, Pan WH, Chen CH. Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks.
Chiang CE, Wang TD, Lin TH, Yeh HI, Liu PY, Cheng HM, Chao TH, Chen CH, Shyu KG, Ueng KC, et al. The Focused Update of the Guidelines of the Taiwan Society of Cardiology TSOC and the Taiwan Hypertension Society THS for the Management of Hypertension.
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International physical activity questionnaire: country reliability and validity. Med Sci Sports Exerc. Liou YM, Jwo CJ, Yao KG, Chiang LC, Huang LH. Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ.
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Download references. The authors express their gratitude to all members of the General Clinical Research Center for their input for this study. This work was supported, in part, by grants from the Ministry of Health and Welfare MOHWTDU-B The funder had no role in study design, data collection and analysis, data interpretation, the decision to publish, or the preparation of the manuscript.
Center for Evidence-based Medicine, Taipei Veterans General Hospital, No. Divison of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan. Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. Division of Preventive Medicine and Health Service, Research Institute of Population, Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
General Clinical Research Center, Taipei Veterans General Hospital, No. You can also search for this author in PubMed Google Scholar. HMC, SHS, CHC, WCY, CYG, SYC, and CEC designed the study and the protocol. HMC and CEC wrote the manuscript. SMY revised the manuscript. All authors read and approved the final manuscript.
Correspondence to Hao-Min Cheng or Chern-En Chiang. The protocol was approved by the institutional review board at Taipei Veterans General Hospital —A on 29 May Informed consent will be obtained from all patients enrolled in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. SPIRIT Checklist: Recommended items to address in a clinical trial protocol and related documents.
DOC kb. Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions. Cheng, HM. et al. Guiding Hypertension Management Using Different Blood Pressure Monitoring Strategies GYMNs study : comparison of three different blood pressure measurement methods: study protocol for a randomized controlled trial.
Trials 20 , Download citation. Received : 26 September Accepted : 15 April Published : 10 May Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Study protocol Open access Published: 10 May Guiding Hypertension Management Using Different Blood Pressure Monitoring Strategies GYMNs study : comparison of three different blood pressure measurement methods: study protocol for a randomized controlled trial Hao-Min Cheng ORCID: orcid.
Abstract Background Home blood pressure BP and unattended automated BP uAOBP monitoring have been recommended by guidelines for the care of hypertensive subjects.
Discussion To our knowledge, this is the first prospective double-blind randomized controlled trial to assess the optimal guiding strategy for hypertension. Trial registration ClinicalTrials. Background Throughout middle and old age, blood pressure BP is strongly and directly related to vascular and all-cause mortality [ 1 ].
Study population Patients with hypertension will be recruited at outpatient clinics, from advertisements, and at Taipei Veterans General Hospital. Study protocol Patients will be randomized to have hypertension management decisions made based on uAOBP, home BP, or central BP monitoring.
Full size image. Discussion Rationale Taking BP measurements is a clinical procedure of considerable importance because it serves as an imperative foundation in the management of hypertension, which is the most significant cardiovascular risk factor across the globe [ 26 ].
Challenges in using office BP to guide the clinical management of hypertension Using conventional office BP in the management of hypertension is heavily affected by the busy and hurried clinical environment.
Is uAOBP the best BP measurement technique? Double-blind versus open-label design for the treatment strategies We designed this study as a double-blind study.
Blood pressure threshold We adopt a common BP target based on the recommendation of the latest hypertension guideline for uAOBP and home BP [ 6 ]. Limitations Although we will count the pills held by a patient at each visit, poor medication adherence patients may be a limitation of this trial.
Conclusion The GYMNs trial is ongoing and due to complete in Trial status This protocol is version 1, dated 19 March Abbreviations BP: Blood pressure DBP: Diastolic blood pressure DDD: Daily defined dose ECG: Electrocardiogram IPAQ-SF: International Physical Activity Questionnaire Short Form LV: Left ventricular SBP: Systolic blood pressure SF Short Form uAOBP: Unattended automated office blood pressure.
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Medications may help lower your blood pressure. Techniqus dietary and lifestyle changes, such as exercising more, improving your Support healthy blood sugar levels, and limiting Blood pressure management techniques pressrue alcohol, could also pressurf. High blood pressure Blood pressure management techniques often has no symptoms but is a major risk of heart disease and stroke. A reading of — over less than 80 is elevated blood pressure. Research suggests that both aerobic and resistance exercise can help delay or manage blood pressure, and that after exercising, blood pressure may be lower for up to 24 hours after. Regular exercise means you regularly increase your heart and breathing rates.
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