Improved Blood Pressure Control Associated With a Large-Scale Hypertension Program

Abstract

Hypertension affects 65 million adults in the United States (29%)¹ and is a major contributor to cardiovascular disease.² Although effective therapies have been available for more than 50 years,³ fewer than half of Americans with hypertension had controlled blood pressure in 2001-2002.¹ Many quality improvement strategies for control of hypertension exist,^4-10 but to date, no successful, large-scale program sustained over a long period has been described. A review of 72 clinical trials¹¹ identified several interventions that improve blood pressure control in primary care settings, with the strongest evidence for an organized, comprehensive system of regular population review and intervention. Kaiser Permanente Northern California (KPNC) is a not-for-profit, integrated health care delivery system caring for more than 2.3 million adult members, with comprehensive inpatient and outpatient care provided through 21 hospitals, 45 medical facilities, and more than 7000 physicians. In 2001, KPNC developed a system-level, multifaceted quality improvement program for hypertension. We describe the details of the development and implementation of this program and its associated results for the period between 2001-2009.