The Role of Retail Health in Hypertension Control

While the prevalence of hypertension has remained relatively stable over the years, hypertensive patients have been gaining better control over their blood pressure.

A recent National Center for Health Statistics (NCHS) data brief provides estimates of the number of Americans with hypertension and how the management of the condition has changed.

The findings indicated that the percentage of Americans with hypertension has remained around 28% to 29%, but the good news is that controlled hypertension has risen from 31.5% in 1999 to 54% in 2014.

While many variables may be contributing to the improvement in controlled hypertension, Kristen Marjama, DNP, FNP-BC, manager of clinic education and development for Walmart Care Clinic, toldContemporary Clinicthat retails clinics in particular have played an important role in identifying patients at risk, undiagnosed, or on a blood pressure medication but do not have their blood pressure controlled.

“Nurse practitioners and physician assistants in retail clinics play a vital role in evaluating, treating, and monitoring patients with hypertension,” Dr. Marjama maintained.

One reason patients may find retail clinics an ideal setting to get their blood pressure checked is the easy access.

“The convenience of the retail clinic enhances the ability of the patient to stop in for a 1-month blood pressure check or come back for their 6-month refill,” Dr. Marjama said. “Not to mention that the pharmacy is just a few steps away.”

Some key findings from the NCHS data brief were that hypertension prevalence increased with age and was higher among black patients (41.2%) compared with white (28%), Asian (24.9%), or Hispanic (25.9%) patients.

In addition, patients between ages 18 and 39 were less likely to have controlled hypertension than those ages 60 or older. These findings may encourage retail clinicians to target younger patients with hypertension as well as younger patients who may not even know they have high blood pressure.

“Many patients with uncontrolled hypertension are walking around without any signs or symptoms,” Dr. Marjama said. “The patient who is at risk or undiagnosed does not typically walk in [to a retail clinic] to be seen for his or her blood pressure, [so] it’s a best practice to obtain blood pressure on all patients with any chief complaint.”

When a patient is found to have hypertension, the goal for retail clinicians is to provide education about what hypertension is, inform them about how the condition can affect their well-being, and explain what they can do to control their blood pressure and why they should do so, Dr. Marjama said.

Around 30% of men and 28% of women have hypertension, according to the NCHS data brief. However, more women have controlled hypertension than men (56.3% versus 50.6%).

“Despite the remarkable progress in hypertension control that has been noted in the United States

over the years, there is still room for improvement to meet the goal of Healthy People 2020

(61.2% by 2020),” the researchers concluded.

Healthy People 2020, as well as the Million Hearts Initiative and the Community Preventive Services Task Force, has been advocating for an increased public awareness of the health benefits of improving blood pressure control.

The researchers noted that hypertension is directly linked with an increased risk for cardiovascular disease.