Organization/Delivery of Health Care

Local clinical hypertension specialists are developing a hypertension reduction plan for their area

About 50 million adults in the United States have hypertension, and about 40 million of these patients do not have their blood pressure controlled to a goal of less than 140/90 mm Hg. This increases their risk of stroke, congestive heart failure, coronary heart disease, and kidney failure.

The American Society of Hypertension's regional chapter in South Carolina has begun a 5-year program in that State to train a network of regional primary care physicians (PCPs) to become certified clinical hypertension specialists. Since patterns of hypertension vary across communities, these local specialists are in the best position to help develop a hypertension reduction plan for their area, suggest the researchers who are from the Medical University of South Carolina and the Ralph H. Johnson Veterans Affairs Hospital in Charleston. Their research was supported in part by the Agency for Healthcare Research and Quality (HS10871).

The researchers note, for example, that the median age of the population is rising more rapidly in the "Sunbelt," as retirees from the north relocate to warmer climates. The Southeast has a larger percentage of blacks than the United States overall. Both blacks and Hispanics have a higher rate of hypertension than whites. The South Carolina chapter of the American Society of Hypertension anticipates that locally trained hypertension specialists can educate local primary care providers about procedures that promote blood pressure (BP) control, receive referrals of patients with complicated hypertension, monitor progress in meeting hypertension control goals, provide feedback to clinicians, and participate in multicenter trials. The 5-year plan is to develop a State-wide network of hypertension specialists that includes about 5 percent of PCPs practicing in South Carolina.

For more information, see "American Society of Hypertension regional chapters: Leveraging the impact of the clinical hypertension specialist in the local community," by Brent M. Egan, M.D., Daniel T. Lackland, Ph.D., and Jan N. Basile, M.D., in the April 2002 American Journal of Hypertension 15, pp. 372-379.


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