Background on Hypertension

High blood pressure (Hypertension) is a widespread, chronic condition that affects approximately 47% of adults in the United States. Hypertension predicts major cardiovascular, renal, and cerebrovascular events, including heart attack and stroke. Thus, it is critically important to detect, correctly diagnose, and effectively treat hypertension. Clinical evidence and practice have rapidly evolved with regards to hypertension care. However, despite knowing more about how to lower blood pressure (BP) to avoid severe outcomes, overall blood pressure control remains poor, with less than half of hypertensive adults meeting a goal <140/90 mmHg. Additionally, clinical practice guidelines often disagree on the recommended course of treatment.

Although there are multiple factors that contribute to the low rate of BP control, the complexity of Hypertension is a partial cause. Managing hypertension is a highly-variable process with complex information needs and clinical consideration. Diagnosis requires multiple, accurate measurements, which may be taken at the patient's home or during office visits. Treatment can require both behavioral and lifestyle modification and one or more medications. Challenges can include inaccurate measurements, adverse reactions to medication, and the difficulty for the patient to implement lifestyle modification. Additionally, many patients with high cardiovascular risk are at risk of adverse reactions to treatment or comorbidities. Some patients may experience secondary hypertension as a symptom of other conditions, requiring specific diagnostic testing and treatments.

Clinical decision support (CDS) tools for hypertension must therefore be designed to simplify the process of diagnosing and managing hypertension, addressing the needs of both patients and primary care providers while adhering to areas of agreement within the guidelines. Our tool is designed to be a patient-facing web tool, allowing patients to easily access their identified personal preferences for care, their recorded history of blood pressure measurements, and their prescribed treatments. This tool is intended to serve an educational purpose, providing users with information about hypertension and related health risks, as well as information about what to do if they experience an adverse reaction to treatment. For care team users, we expect that this tool will be used during office visits to provide care recommendations based on preferences, feasibility of treatments, and patient health information. Our goal is that this tool will streamline the process of diagnosing and managing hypertension during office visits, providing accurate and guideline-supported care recommendations to improve patent health outcomes and guideline adherence.