Unrecognized and undertreated high blood pressure is a major risk factor for cardiovascular diseases, such as heart failure and stroke. Studies show that optimal blood pressure control prevents 19-56% of coronary heart disease events in men, and 31-57% of coronary heart disease events in women. Evidence shows a modest reduction of 5 mmHg in systolic blood pressure can reduce coronary heart disease events by 9.0% and stroke by 14.0%. Although ADH LHUs do not provide direct medical care for those with hypertension, it is important that all clients who are detected to have high blood pressure to be referred for appropriate management.

• Local physicians, Advance Practice Registered Nurses

Since 2016, ADH LHU patients detected to have elevated blood pressure, both previously diagnosed and undiagnosed, are being referred to medical care by LHU nurses. The ADH electronic health record system was configured to collect referral data for persons with elevated blood pressure. These referrals ensure continuity of care for patients with elevated blood pressure who would otherwise fall through the cracks.

Strategy 1: Update ADH policy for referrals and create a referral mechanism (letter) in Greenway as it relates to elevated blood pressures.

Strategy 2: ADH must establish community connections, as referring 80% of people for follow up services will require access to care and treatment.

Strategy 3: Educate patients on what HTN is and the importance of care.

New American College of Cardiology/American Heart Association High Blood Pressure Guidelines Lower Definition of Hypertension. American College of Cardiology, 2017. Available at:  https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017