Organised systems of regular follow-up and review can improve blood pressure control

Clinical question: 
What interventions can improve control of blood pressure in patients with hypertension?
Bottom line: 
An organised system of registration, recall and regular review, allied to a vigorous stepped care approach to antihypertensive treatment, reduced blood pressure and all-cause mortality in a single, large randomised control trial. Health professional (nurse or pharmacist) led care appears to be a promising way of delivering care but requires further evaluation.
Caveat: 
Trials of educational interventions directed at patients or health professionals were heterogeneous and appear unlikely to be associated with large net reductions in blood pressure by themselves.
Context: 
Hypertension is a common problem in general practice. International community based studies show blood pressure goals are achieved in only 25–40% of patients who take antihypertensives.¹ There is a paucity of evidence as to how care for hypertensive patients should be delivered in the community to help improve blood pressure control. 1. Burnier M. Journal of Hypertension 2002;20:1251–3
Review CD#: 
CD005182
PEARLS No: 
269
Date: 
September, 2007
Authored by: 
Brian R McAvoy