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Hypertension
(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.
Medical Management of Adults with Hypertension - MQIC
Care Management Interventions
Click Here for an example of a Hypertension action plan
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Diagnosis Specific Concerns |
Care Management Intervention |
Patient Specific Interventions |
Care Manager Resources |
Patient Resources |
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Assessment |
Assess patients knowledge |
Preparing for the visit |
What to Expect at the Physician Appointment Handout - Preparing for the Appointment |
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Diagnosis Education |
Provide education regarding hypertension diagnosis
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Discuss diagnosis with care manager
Review educational materials provided
Provide teach-back |
Guide to Lowering Blood Pressure - DHHS
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Medication Management |
Provide education on medications
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Create medication list of all current medications including OTC and herbal supplements.
Demonstrate understanding of medications including:
Take medications as prescribed
Review educational material
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What is High Blood Pressure Medicine Medications and Blood Pressure
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Action Plan |
Educate patient on when to call primary care physician Provide patient with hypertension action plan
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Demonstrate understanding of hypertension action plan and when to call physician’s office versus go to Emergency Room Monitor blood pressure at home |
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Smoking |
Provide education on smoking cessation
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Review materials provided on smoking cessation Enroll in a smoking cessation program |
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Nutrition |
Educate on diet recommended by physician Provide education on diet and tools for maintaining diet
Refer patient to a dietitian or nutritionist Create diet plan |
Demonstrate understanding of prescribed diet |
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Activity |
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
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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 |
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| 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 |
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.
Pathophysiology
Toolkits
This section provides information on various toolkits to assist with the care management of hypertensive patients.
Care Management Learning Resources
This section is for care managers who would like to get additional more specific information relating to hypertension.
