HYPERTENSION INFOGRAPHIC
[PROVIDER]
📊 WHAT IS HYPERTENSION?
Hypertension is defined as persistent systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg 1
- Affects 116 million adults in the US and over 1 billion adults worldwide 1
- A major risk factor for heart disease, stroke, heart failure, kidney disease, and death 1, 2
- Only 44% of US adults with hypertension have their blood pressure controlled to <140/90 mmHg 1
🎯 BLOOD PRESSURE TARGETS
For most adults <65 years: <130/80 mmHg 1
For adults ≥65 years: SBP <130 mmHg 1
For patients with diabetes or chronic kidney disease: <130/80 mmHg 3
💊 FIRST-LINE MEDICATIONS
The three pillars of hypertension drug therapy 1:
- Thiazide or thiazide-like diuretics (hydrochlorothiazide, chlorthalidone) 1, 3
- ACE inhibitors or ARBs (enalapril, candesartan) 1
- Calcium channel blockers (amlodipine) 1
Each 10 mmHg reduction in systolic blood pressure decreases cardiovascular events by 20-30% 1
🏃 LIFESTYLE MODIFICATIONS (ESSENTIAL FOR ALL)
Recommended for everyone with blood pressure >120/80 mmHg 3
- Weight loss and avoid obesity (waist-to-height ratio <0.5) 4
- Dietary sodium reduction and potassium supplementation 1, 4
- Moderate-intensity aerobic exercise 30 minutes on 5-7 days per week 4, 5
- Limit alcohol: 2 drinks/day for men, 1.5 for women 4
- Smoking cessation 4
- Stress reduction through mindfulness or meditation 4
- Reduce exposure to cold temperature (particularly in winter months) 5, 6
👥 TEAM-BASED CARE APPROACH
A team-based care approach is recommended for all adults with hypertension (Class 1, Level A evidence) 4
Your care team should include 4:
- Lead clinician: physician or advanced practice nurse 4
- Clinical support: pharmacist, nurse, physician assistant, medical assistant, or community health worker 4
- Administrative support: scheduler, receptionist 4
- Specialist referral system for difficult-to-control cases 4
Team-based care reduces systolic and diastolic blood pressure and improves blood pressure control compared to usual care 4
🏠 HOME BLOOD PRESSURE MONITORING
Follow-up should include home blood pressure monitoring (Class 1, Level A evidence) 4
Key monitoring principles 4:
- Use validated, automated devices with proper cuff size 4
- Measure blood pressure at the same time daily 4
- Take readings after 5 minutes of rest, sitting with back supported 4
- Record all readings accurately and bring monitors to clinic visits 4
- Base clinical decisions on average of readings from ≥2 occasions 4
⚠️ WHEN TO INTENSIFY TREATMENT
Add a third medication if blood pressure remains elevated on two drugs 6
Blood pressure 130-160/90-100 mmHg represents Stage 2 hypertension requiring treatment intensification 6
Follow-up within 1 month after medication changes (telephone, telehealth, or clinic visit) 4
🌡️ SEASONAL CONSIDERATIONS
Blood pressure varies with temperature 5:
- Winter: Blood pressure increases by average 5/3 mmHg (systolic/diastolic) 5
- Summer: Blood pressure decreases 5
- Cardiovascular hospitalizations increase substantially during colder periods 5
- Elderly patients show greater blood pressure variability with temperature changes 5
Maintain appropriate clothing and heating strategies to stabilize body temperature 5
🎯 ADDRESSING SOCIAL FACTORS
Social determinants of health should inform treatment recommendations (Class 1, Level B-NR evidence) 4
Important factors affecting blood pressure control 4:
- Access to healthy food and safe exercise environments 4
- Health literacy and educational background 4
- Age, gender, and race/ethnicity 4
- Availability of health services 4
Addressing unmet social needs improves blood pressure and lipid management 4
📈 QUALITY IMPROVEMENT
Performance measures should be used to improve hypertension care (Class 2a, Level B-NR evidence) 4
Essential program elements 4:
- Patient educational materials on hypertension 4
- Timely follow-up within 1 month of treatment changes 4
- Medication adherence monitoring using pharmacy fill data 4
- Provider-specific performance reports 4
- Regular team meetings (at least quarterly) 4
🚨 COMMON PITFALLS TO AVOID
Do not overlook medication adherence as a common cause of uncontrolled hypertension 6
Do not assume resistant hypertension without optimizing the three first-line medication classes at appropriate doses 7
Consider seasonal blood pressure variations when symptoms of overtreatment appear with temperature rise 5
Screen for secondary causes if clinically indicated (though <10% of cases) 7
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