Systemic Implementation Strategies to Improve Hypertension: The Kaiser Permanente Southern California Experience John J. Sim, MD, Joel Handler, MD, Steven.

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Presentation transcript:

Systemic Implementation Strategies to Improve Hypertension: The Kaiser Permanente Southern California Experience John J. Sim, MD, Joel Handler, MD, Steven J. Jacobsen, MD, PhD, Michael H. Kanter, MD Canadian Journal of Cardiology Volume 30, Issue 5, Pages 544-552 (May 2014) DOI: 10.1016/j.cjca.2014.01.003 Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 1 Kaiser Permanente Southern California hypertension control rates. HTN, hypertension. Canadian Journal of Cardiology 2014 30, 544-552DOI: (10.1016/j.cjca.2014.01.003) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 2 Kaiser Permanente Southern California population overview. Canadian Journal of Cardiology 2014 30, 544-552DOI: (10.1016/j.cjca.2014.01.003) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 3 Kaiser Permanente hypertension algorithm. ACE, angiotensin-converting enzyme; ACEI, angiotensin-converting enzyme inhibitor; BP, blood pressure; CKD, chronic kidney disease; CVA, cerebrovascular accident; eGFR, estimated glomerular filtration rate; HCTZ, hydrochlorothiazide; MI, myocardial infarction; NNT, number needed to treat; NSAID, nonsteroidal anti-inflammatory drug; TIA, transient ischemic attack. Canadian Journal of Cardiology 2014 30, 544-552DOI: (10.1016/j.cjca.2014.01.003) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 4 Combination pill use and hypertension control at Kaiser Permanente Southern California. Since 2005, when the combination of lisinopril/HCTZ was advocated, hypertension control rates have steadily increased, paralleling the proportion of those prescribed the lisinopril/HCTZ combination pill. HCTZ, hydrochlorothiazide; HTN, hypertension. Canadian Journal of Cardiology 2014 30, 544-552DOI: (10.1016/j.cjca.2014.01.003) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions