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September 23, 2019Journal of Clinical Hypertension54 citationsOpen Access

Scaling up effective treatment of hypertension—A pathfinder for universal health coverage

TFThomas R. FriedenCVCherian VargheseSKSandeep P. Kishore

Key Result

Standardized hypertension treatment programs utilizing drug- and dose-specific protocols, fixed-dose combinations, and team-based care can overcome health system barriers and could save 100 million lives worldwide over 30 years.

Structured PICO

P
Population
People with hypertension worldwide
I
Intervention
Hypertension management program (Resolve to Save Lives), standardized treatment protocols, elimination of artificial trans fat, and reduction of dietary sodium
O
Outcome
Hypertension control rates and lives saved

Scaling up standardized hypertension treatment protocols and public health interventions could save 100 million lives globally over 30 years.

Limitations

  • Irregular or absent supply of quality-assured medications due to insufficient financing and suboptimal procurement
  • Practitioner resistance to automated blood pressure monitors and task sharing with nonphysician health workers
  • Difficulties implementing information systems due to patient identification, paper-based systems, and limited internet bandwidth

Abstract

High blood pressure is the world's leading cause of death, but despite treatment for hypertension being safe, effective, and low cost, most people with hypertension worldwide do not have it controlled. This article summarizes lessons learned in the first 2 years of the Resolve to Save Lives (RTSL) hypertension management program, operated in coordination with the World Health Organization (WHO) and other partners. Better diagnosis, treatment, and continuity of care are all needed to improve control rates, and five necessary components have been recommended by RTSL, WHO and other partners as being essential for a successful hypertension control program. Several hurdles to hypertension control have been identified, with most related to limitations in the health care system rather than to patient behavior. Treatment according to standardized protocols should be started as soon as hypertension is diagnosed, and medical practices and health systems must closely monitor patient progress and system performance. Improvement in hypertension management and control, along with elimination of artificial trans fat and reduction of dietary sodium consumption, will improve many aspects of primary care, contribute to goals for universal health coverage, and could save 100 million lives worldwide over the next 30 years.

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Cite This Study

Frieden et al. (2019) conducted a review in Hypertension. Hypertension control programs (HEARTS technical package) was evaluated. Standardized hypertension treatment programs utilizing drug- and dose-specific protocols, fixed-dose combinations, and team-based care can overcome health system barriers and could save 100 million lives worldwide over 30 years.

synapsesocial.com/papers/6a167227028422572a624ac7https://doi.org/10.1111/jch.13655
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