Reducing Stroke Risk by Managing Hypertension

Individuals with high blood pressure are one and a half times more likely to suffer from a stroke than those who maintain a normal blood pressure. High blood pressure carries other risks, including heart failure, vision loss, heart attack, and kidney disease.

Although damaging, high blood pressure is controllable. People with high blood pressure who eat a well-balanced diet, limit alcohol, don’t smoke, exercise regularly, manage their weight, and adhere to their medication can improve their quality of life and reduce their risk of negative outcomes. The American Heart Association recommends the key to better control of blood pressure is a strong doctor-patient partnership.

Kyra Gambrel, NP from CHI Saint Joseph Medical Group – Cardiology in London, works to facilitate a strong doctor-patient partnership in her practice. This partnership has demonstrated measurable improvements in blood pressure control among her patients.

Describe your usual process when engaging with patients who have been diagnosed with high blood pressure.

When I first encounter a hypertensive patient, I like to gather a detailed health history and physical including recent symptoms and current and past medications.  I become familiar with my patients in effort to gauge their understanding of their diagnosis, their willingness to comply with therapy, and their support and access to health care. 

From your experience, what is the most important part of continuing to engage patients in the management of their condition?

Patients should be taught to know when blood pressure levels or symptoms indicate a problem and when to respond with appropriate actions such as adjusting medication, initiating a call to a health care provider, or when to call 911.  I like to sit down with patients and their families and discuss how to make major lifestyle modifications to reduce their risk for cardiovascular disease. Working together to establish blood pressure goals helps patients adhere to home monitoring, medication regimens (even in the absence of symptoms and despite minor side effects), and to maintain regular contact with my office for monitoring progress.

Do you have any tips for other practices to improve blood pressure control with their patients?

  1. Get to know your patients and their families.
  2. Help your patients choose a home blood pressure monitor.
  3. Collaborate to set goals.
  4. Encourage a blood pressure log for review on visits.
  5. Motivate patients to promote adherence.

For more information on guidelines of care for patients with high blood pressure, see CHI Saint Joseph Health Partners Quality Matters – Blood Pressure Control.