Improving Hypertension _ Diabetes Control and Prevention
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making the change: Lifestyle modification Tips to improve health and keep blood pressure under control

couple biking Patients have the power to lower their blood pressure (BP) and live a healthy, full life. This patient tip sheet  from the Million Hearts® campaign provides tips that you can share with patients on how to eat less salt, check their own BP at home, and learn about medications. 

Lifestyle modifications have direct effect on BP readings. Patients may be more motivated to change behaviors if they better understand the expected outcome of the change. Read more about how small lifestyle changes can impact blood pressure readings.
 
Self-monitoring: encourage your patients to monitor Blood Pressure at home

bp monitor One of the most effective ways to engage patients in their hypertension care is to have them take their own BP. Your practice may want to consider offering patient education around self-management of BP and annual calibration of patient's home blood pressure monitors. 

Download  the Blood Pressure Measurement Instructions resource from the American Heart Association (AHA) and share it with patients to help guide them in accurately monitoring their BP at home.
PATIENT AND FAMILY ENGAGEMENT: 
a four-phase approach 

Quality Insights created a four-phase approach to patient and family engagement. This approach can be helpful in implementing a protocol for self-management of blood pressure (SMBP) within your practice.   Click here to access the specifics of the phases. 

And remember, Quality Insights is here to support your implementation efforts.

goal setting: Hypertension Action Plan templates you can use to help patients set achievable goals

success Many patients respond well to specific goals. A hypertension action plan is one tool that can help patients set very specific goals to manage their hypertension. 

Download one of the following Hypertension Action Plan templates to help guide you in establishing action plans for your patients with hypertension.
s.i.m.p.l.e. method: million hearts®  tip sheet outlines an effective strategy to improve medication adherence

med adherence guide
Medication adherence is critical to successful hypertension control for many patients. However, according to the Million Hearts national campaign, only 51% of Americans treated for hypertension follow their healthcare professional's advice when it comes to their long-term medication therapy.  

Adherence matters. High adherence to antihypertensive medication is associated with higher odds of BP control, but non-adherence to cardio-protective medications increases a patient's risk of death from 50 percent to 80 percent.

As a healthcare professional, you can empower patients to take their medications as prescribed. Effective two-way communication is critical; in fact, it doubles the odds of your patients taking their medications properly. Try to understand your patients' barriers and address them honestly to build trust. 

Quality Insights encourages you to reference the Million Hearts® tip sheet for health care professionals, Improving Medication Adherence Among Patients with Hypertension, for additional information related to medication adherence, and details about the S.I.M.P.L.E. method that healthcare provides employ to improve medication taking behaviors. 
the trifecta: effectively Managing your Cholesterol, Blood Pressure and Weight

health_food_heart.jpg The  American Heart Association - Understanding and Managing High Blood Pressure is a comprehensive guide for patients to help them understand BP and the importance of keeping their BP under control. 

Visit  this page for information on how patients can become more involved in the management of their cholesterol, blood pressure and weight. It offers many tips to help patients effectively monitor their blood pressure, change their lifestyle and reduce their risks of being unhealthy.
patient handouts: access the Heart Health Outreach Toolkit from NIH

The National Heart, Lung, and Blood Institute (NIH) created this online  outreach toolkit featuring patient resources focused on nutrition, physical activity, and healthy lifestyles. 

For example, the  28 Days Towards a Healthy Heart  tip sheet offers ideas for simple ways to incorporate heart health into every day of the month.
keeping BP Under control: Self-Management Protocol for Controlling Hypertension in Adults

Protocol for Controlling Hyp The blood pressure goal is set by a combination of factors including scientific evidence, clinical judgment, and patient tolerance. For most people, the goal is <140 and <90; however some individuals may be better served by other BP goals. 

Lifestyle modifications (LM) should be initiated in all patients with hypertension and patients should be assessed for target organ damage and existing cardiovascular disease. 

Self-monitoring is encouraged for most patients throughout their care and requesting and reviewing readings from home and community settings can help in achieving and maintaining good control. For patients with hypertension and co-existing medical conditions, specific medications should be considered. This clinical treatment protocol can be modified to meet your needs.
 
Training Video: Patient Self-Management of Blood Pressure

video icon The How to Monitor Your Blood Pressure at Home video from the AHA explains the proper way to monitor BP at home. It shows the step-by-step process and includes important tips on what someone should and should not do to ensure an accurate home reading. The video is also available in Spanish.

Share the video with all patients in your practice diagnosed with hypertension or consider running the video while patients wait in the exam room for the provider.
 
contact information

For more details about the Improving Hypertension and Diabetes Care & Prevention project, please contact Ashley Biscardi, Sarah Toborowski, Ryan Williamson, and Danielle Nugent.
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This publication was supported by the Cooperative Agreement Number 1U58DP004799-01 from the Centers for Disease Control and 
Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the 
Centers for Disease Control and Prevention. 
Publication number: DEDPH-HD-041912