What is high blood pressure?

Hypertension, or high blood pressure (BP), occurs when the force of the blood against the walls of the arteries is consistently too high. If left unchecked, the disease can lead to heart disease or stroke.

Classification of BP

BP guidelines from the American Heart Association/American College of Cardiology provide four BP categories based on the average of two or more in-office readings on two or more occasions:

  • Normal:
  • High: 120-129 mm Hg SBP and
  • Stage 1 hypertension: 130-139 mm Hg SBP or 80-89 mm Hg DBP and
  • Stage 2 hypertension: PAS ≥ 140 mm Hg or PAD ≥ 90 mm Hg

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What doctors wish patients knew about high blood pressure

High BP is usually asymptomatic, can damage blood vessels inconspicuously and lead to serious health problems.

In a 2022 “AMA Moving Medicine” video update on hypertension, Rachel Villanueva, MD, president of the National Medical Association (NMA), and clinical assistant professor of obstetrics/gynecology at the Grossman School of Medicine in New York University notes that “high blood pressure doesn’t have to make you feel bad about causing damage, causing vision problems, kidney problems, heart problems, and leading to heart disease and other chronic illnesses. »

Heart health statistics reinforce the need for all physicians and their patients to prioritize the control of hypertension. According to stats shared by AMA’s Release the Pressure Toolkit:

  • Nearly half of American adults have high blood pressure
  • About 860,000 people die each year from heart disease in the United States
  • The prevalence of high BP in black women is almost 42% higher than in white women in the United States, and 14% higher in black men than in white men

Patient-centered approaches help reduce high BP

Although there is no cure for high BP, it is important for patients to take steps to improve their health outcomes, such as making effective lifestyle changes and taking medication to lower BP (PDF) as prescribed by their doctor.

Perform self-measurement of blood pressure (SMBP)

Self-measured blood pressure (SMBP) refers to blood pressure measurements obtained outside of a physician’s practice or clinical setting, usually at home. When combined with clinical support (for example, one-to-one or telehealth and education), SMBP can help improve the quality and accessibility of care for people with high BP and improve the BP control.

The AMA’s 7-step SMBP Quick Guide (PDF) is a reference for physicians and healthcare teams to help train patients in SMBP monitoring. It should also be noted that the Current Procedural Terminology (CPT®) code set now includes SMBP.

Measure BP accurately

Measuring blood pressure is standard practice in most practices, but it can be easy to get inaccurate readings. The AMA’s Infographic for Office Blood Pressure Measurement (PDF) provides an easy way to get the most accurate blood pressure readings and is also available in Spanish (PDF).

For healthcare teams, using a Blood Pressure Measurement Skill (PDF) can help team members understand the importance of accurate blood pressure measurement.

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Patients can take these steps to lower their high blood pressure

Treating High BP Readings

Establish best practices for treating a patient’s uncontrolled or elevated BP, with treatment action plans and internal protocols. Additionally, set workflow process for the management of patients with high blood pressure, with or without a diagnosis of hypertension.

Partner with patients and monitor success

Partner with patients, families and communities to promote self-management that tackles high blood pressure. Use collaborative patient-centered communication strategies (PDF) with patients to increase engagement and promote adherence to their care plan.

A care plan can include appropriate lifestyle changes, such as eating healthy foods, avoiding unhealthy alcohol consumption, and monitoring sodium intake.

Team up with peers

Network with peers and collaborate on patient-centered approaches to improving high BP:

  • Discover best practices for engaging patients in a treatment plan
  • Measure, Act and Partner (MAP) to help patients control their BP
  • Discuss and follow evidence-based treatment protocols
  • Guide your healthcare team in implementing an AP quality improvement program
  • Participate in recognition programs for efforts focused on BP control in the populations you serve

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Thousands of devices measure blood pressure. Know who to trust.

The AMA has developed online tools and resources created using the latest evidence-based information to help physicians diagnose and manage high blood pressure in their patients. These resources are made available to all physicians and health systems as part ofTarget: AP™, a national initiative co-led by the AMA and the American Heart Association (AHA).

Other key high BP AMA resources include:

Review by: Kate Kirley, MD, MS, Director, Chronic Disease Prevention and Programs

Reviewed on: May 2022

Norma A. Roth