Mission 75/28: A National Initiative to Enhance Hypertension Control in Lithuania

Objective: Lithuania ranks among Europe's highest-risk regions for cardiovascular diseases (CVDs), with hypertension as a leading contributor to morbidity and mortality. Despite ongoing efforts, blood pressure (BP) control remains suboptimal. Analysis of the Foxus database (293,699 patients with ICD-10 I10–I11) shows only 48.1% achieved BP <140/90 mmHg, primarily due to poor medication adherence. This gap drives higher hospitalization rates, increased healthcare costs, and preventable premature deaths. To address this, the Lithuanian Societies of Hypertension, Cardiology, and Family Physicians, together with UAB “Servier Pharma” and “Microlife,” launched Mission 75/28. The project aims to raise awareness of hypertension control and medication adherence, targeting a 75% BP control rate (<140/90 mmHg) among patients in participating institutions by 2028. Design and method: The initiative has two core components: Accredited multidisciplinary educational program — training for physicians, nurses, pharmacists, and patients based on the 2024 ESH MASTERplan guidelines. Sessions cover Lithuania's hypertension epidemiology, accurate BP measurement, holistic treatment (lifestyle + pharmacotherapy), adherence strategies (especially fixed-dose combinations), and collaborative roles of nurses/pharmacists in patient support. Retrospective real-world study — using anonymized Foxus database data the study evaluates demographics, comorbidities, medications, healthcare utilization, CVD hospitalizations, and BP values in adults with hypertension from participating centers. The primary endpoint is the one-year BP control rate post-intervention vs. baseline; secondary endpoints include institutional trends and predictors of better control. Results will be published internationally. Results: The rollout is structured in two stages. Stage 1 is underway in 8 institutions, providing intensive training, validated BP devices, education materials, and data tools. Stage 2 plans voluntary expansion to reach up to 50% of Lithuania's family physicians within 3 years through society outreach, conferences, networks, and digital campaigns, with ongoing mentorship and refinements based on pilot feedback. Dissemination includes conferences, publications, and partner-led awareness activities. Conclusions: Mission 75/28 strengthens Lithuania's cardiovascular prevention by focusing on hypertension management in treated patients, integrating guideline-based education, adherence support, and outcome evaluation to promote consistent primary care practice and contribute to gradual reductions in CVD events and costs.