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(Updated September 5th, 2018)

Hypertension Definition

High blood pressure is when blood flows through blood vessels (arteries) at higher than normal pressures. There are two main types of high blood pressure: primary and secondary high blood pressure. Primary, or essential, high blood pressure is the most common type of high blood pressure. This type of high blood pressure tends to develop over years as a person ages. Secondary high blood pressure is caused by another medical condition or use of certain medicines. This type usually resolves after the cause is treated or removed. National Heart Lung and Blood Institute

Hypertension Guidelines

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

Update on blood pressure parameter guidelines from the American College of Cardiology and the American Heart Association (New!)

Medical Management of Adults with Hypertension - MQIC



Care Management Interventions

Click Here for an example of a Hypertension action plan

Diagnosis Specific Concerns

Care Management Intervention

Patient Specific Interventions

Care Manager Resources

Patient Resources


Assess patients knowledge

Preparing for the visit

Cardiovascular Self-Management Tool

What to Expect at the Physician Appointment

Handout - Preparing for the Appointment

HTN - Questions to Ask Your Doctor

Hypertension Health Care Tracker

Diagnosis Education

Provide education regarding hypertension diagnosis

  • Causes
  • Risks
  • Symptoms
  • Treatment

Discuss diagnosis with care manager


Review educational materials provided


Provide teach-back

Guide to Lowering Blood Pressure - DHHS


Million Hearts



Blood Pressure Log

Know the Facts

Medication Management



Provide education on medications



Create medication list of all current medications including OTC and herbal supplements.


Demonstrate understanding of medications including:

  • Name and purpose
  • Dosage
  • When to take
  • How to refill

Take medications as prescribed


Review educational material


Types of Blood Pressure Medications

Free or Low Cost Medications - State of Michigan



Managing Your Medications

What is High Blood Pressure Medicine

Medications and Blood Pressure



Action Plan

Educate patient on when to call primary care physician

Provide patient with hypertension action plan


Demonstrate understanding of hypertension action plan and when to call physician’s office versus go to Emergency Room

Monitor blood pressure at home

Hypertension Action Plan

SMART Goals for Hypertension

Hypertension Control - Action Steps for Clinicians

Hypertension Action Plan



Provide education on smoking cessation


Review materials provided on smoking cessation

Enroll in a smoking cessation program

Smoking Cessation in Michigan



Educate on diet recommended by physician

Provide education on diet and tools for maintaining diet

  • Good vs bad food
  • Reading food labels

Refer patient to a dietitian or nutritionist

Create diet plan

Demonstrate understanding of prescribed diet

Potassium and Hypertension

Weight Loss and Blood Pressure Control


Healthy High Blood Pressure Recipes

Fact Sheet - Sodium


Provide education on exercise and hypertension if recommended by physician

Create action plan

Provide examples of different types of exercise

Educate patient on signs and symptoms of when to stop exercising

Check with provider prior to starting an exercise regimen

Understand warning signs and when to stop exercising

Follow recommended treatment plan

  • Tips- Start slowly
  • Exercise at the same time each day so it becomes a regular part of the day

Physical Activity and Blood Pressure - AHA

Activity Log

Recommendations for Physical Activity in Adults

Managing Stress

Educate patient on healthy ways to manage stress

Refer patient to a behavioral health specialist

Demonstrate understanding of healthy ways to manage stress


How to Lower Your Stress



Four Ways to Deal with Stress

Common Labs and Tests

Instruct patient on proper way to take a blood pressure

Provide education on ordered tests and labs

Review test information

Complete tests as ordered by physician

Home Blood Pressure Monitoring

Procedure for Measurement of Blood Pressure

Home Blood Pressure Monitoring

Blood Pressure Log

For a printable version of the care manager interventions Click Here

This chart is not meant to be an inclusive list of interventions or resources for care management but a starting point in working with patients with hypertension. Always check with your practice regarding the use of guidelines, resources and education.



Hypertension Pathophysiology

The ABCs of hypertension from the National Institute of Health


This section provides information on various toolkits to assist with the care management of hypertensive patients.


Hypertension Toolkit

The Toolkit for Improving Hypertension Care & Outcomes presents several evidence-based strategies that health care provider organizations can use to improve hypertension control among their patients. Developed by the  Wisconsin Collaborative for Healthcare Quality. Free signup is required to access the toolkit.


Hypertension Toolkit

From Molina Healthcare

Care Management Learning Resources

This section is for care managers who would like to get additional more specific information relating to hypertension.


Hypertension and Diet

From the journal Hypertension. Multiple dietery factors and the effect on blood pressure


Hypertension Education

Educational Interventions for Improving Control of Blood Pressure in Patients with Hypertension: A Systematic review Protocol


High Blood Pressure University - Patient Campus

From the Michigan Department of Health and Human Services. The Patient Campus provides individuals in Michigan with resources to use to manage or prevent high blood pressure.  

Reference Guide

2017 Guideline for the Preventions, Detection, Evaluation and Management of High Blood Pressure in Adults

A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Reference Guide

Hypertension Management Action Guide for Health Care Providers

From the Georgia Department of Public Health. Step by step guide to discussing hypertension with the patient.

Reference Guide

Hypertension and Your Kidneys

From the National Kidney Foundation. Provides and overview of hypertension, treatment and its impact on the kidneys.


Hypertension Practice Process - Clinical Pathways

Provides information of standard of care, educational information, teaching materials and community and Health professional resources

Webinars and Presentations

MiCMRC Educational Webinar

Feb 14 2018

To receive a certificate of completion Click Here

Webinar replay video

Presented by

Kristina Dawkins, MPH,  Clinical and Public Health Consultant

Michigan Department of Health and Human Services

Cardiovascular Health, Nutrition, and Physical Activity Section

Heart Disease and Stroke Prevention Unit

MPTCQ Educational Webinar

May 16 2017

To receive a certificate of completion Click Here.

Presented by

Michigan Pharmacists Transforming Care and Quality