Hypertension – The Silent Killer
• Big Problem
Affects 46% of the adult population
• Big Danger
Causes 25% of all cardiovascular disease
• Big Expense
Costs $2,759/uncontrolled hypertensive/year
• Yet- the rate of BP control is 32% worldwide.
Define, Diagnose, Measure, And Manage Hypertension
A clearer, data-driven approach to hypertension – built to improve clinical decisions, patient outcomes, and provider efficiency.
Overview
Hypertension statistics
121M
Common problem
People affected in the United States.
41,000
Deaths per year
Significant morbidity and mortality.
$318-444B
Annual expense
Approximately $2,759 per hypertensive patient per year.
56.8M
Visits per year
A significant provider-management burden.
Poorly defined
Reported as mislabeled, with 20-22% misdiagnosed.
At goal
Reported control rate at 140/90.
TeAM-HTN pilot study
Clinical Decision Support Tool results
BP control
Improvement from 0% to 58% in resistant HTN and 76% in uncontrolled HTN.
Time reduction
Reported provider-time reduction for resistant and uncontrolled HTN.
54%
Abnormal levels
Prevalence of abnormal renin or aldosterone levels.
Office measurement mislabels white-coat HTN.
Once-a-day measurement misses 20-22% with masked hypertension.
TeAM-HTN: Technology Assisted Management of HTN. Military Medicine, October 2020.
CDST advantages
A
Access.
- Reduces provider-management time.
- Opens schedule for additional visits.
- Increases billing opportunities, existing CPT codes for telemedicine visits.
Q
Quality.
- Improves BP control.
- Precision diagnostics targets therapy.
- Improved HEDIS indicators.
- Better Outcomes.
- Reduces malpractice liability.
C
Cost.
- 25% fewer cardiovascular events.
- Reduces provider time.
-
Empowers NP and PA to do the work of the expert physician.
- Lower drug costs.
- Reported ROI >10:1.
Abbreviations and source references
Abbreviations
HTN: Hypertension
aHTN: Apparent resistant HTN / white-coat HTN
rHTN: True resistant HTN – uncontrolled on three or more medications for more than one month
uHTN: Uncontrolled HTN – high BP in the office (aHTN + rHTN)
HEDIS: Healthcare Effectiveness Data and Information Set
ACE: Angiotensin-converting enzyme inhibitor
AA: Aldosterone antagonist
ENaC: Epithelial sodium channel
ROI: Return on investment
References
- Spence JD. Controlling resistant hypertension. Stroke and Vascular Neurology. 2018;0:e000138. doi:10.1136/svn-2017-00013.
- Egan BM, Basile JN, Rehman SU, et al. Plasma renin test-guided drug treatment algorithm for patients with treated but uncontrolled hypertension. American Journal of Hypertension. 2009;22(7):792-801. doi:10.1038/ajh.2009.63.
- Siaki L, Lin V, et al. Feasibility of a Clinical Decision Support Tool to Manage Resistant Hypertension: TeAM-HTN, a Single-arm Pilot Study. Military Medicine. 2020. doi:10.1093/milmed/usaa255.