Getting Blood Pressure to Goal - National Kidney Foundation课件.ppt

Getting Blood Pressure to Goal Rules of Three: 3 drugs 3 months 3 behaviors (Activity-Diet-Control of Tobacco and Alcohol) 3 Partners (Patient–Family–Provider) This program was sponsored by the National Kidney Foundation of Michigan (NKFM) and the Michigan Department of Community Health (MDCH). Funding was provided by a generous grant from NKFM and MDCH and various pharma companies. Continuing Medical Education credit is provided by Wayne State University School of Medicine The program was developed and prepared by: Diane Levine, MD Wayne State University Silas Norman, MD, University of Michigan Rosalind Peters, PhD, RN, Wayne State University Susan Steigerwalt, MD, St. John Hospital With input from the Hypertension Expert Group of NKFM and the expertise and creativity of its members with special thanks to Velma Theisen and Linda Smith Wheelock ACSW, MSBA Conflict of Interest Individual Speakers to Add their information prior to presenting Objectives Discuss the scope and significance of uncontrolled hypertension in U.S. Examine patient and provider factors that contribute to the problem Review current guidelines and BP goals Discuss the Rules of 3 to achieve goal Discuss goal achievement in special populations Scope of the Problem 1 in 4 Americans - 65 million adults 30% increase from 1988-1994 2/3 are untreated or under treated Millions uncontrolled 69% - NHANES 1999-2000 71% - Framingham 1990-1995 50-70% - Ambulatory care practices High-risk groups with hypertension 88% Diabetics – NHANES III 89% CKD - NHANES III Majority of US Hypertensive Patients Not at SBP Goal of 140 mm Hg Unacceptable BP Control Rates Require Increased Awareness, More Aggressive Treatment Significance of HBP Problem 50% of hypertensives are uncontrolled. Up to half are not receiving pharmacologic treatment Antihypertensive therapy can ? Stroke – 30% ? CHF – 40-50% ? CAD – 10-20% ? CAD Events - ~55% ? Mortality – 10%