Challenges of Treating the Hypertension Patient
Hypertension is a disease that impacts approximately 7.5 million Canadians and 75 million Americans. Left uncontrolled, hypertension can lead to heart disease, strokes, kidney disease, dementia, eye problems, as well as many other life-changing and potentially life-threatening problems.
Hypertension is best controlled through regular visits to a healthcare provider, lifestyle changes, home blood pressure checks, and, in some cases, use of anti-hypertension medicine to treat the disease.
As any healthcare provider knows, treating the hypertension patient presents countless challenges. Many hypertension patients do not feel ill, making it difficult to encourage patients to regularly check their blood pressure at home, alter their lifestyle, and consistently take their medication. Non-adherence in the hypertension patient is a major public health issue, and convincing patients they are sick is one of the burdens of the primary healthcare provider.
Suboptimal Blood Pressure Readings
Office blood pressure checks are necessary, but do not present the whole picture of the patient’s progress. There are several studies that illustrate some patients exhibit white coat syndrome at office visits: blood pressure that is above normal range in a clinic setting, but normal in other settings. Conversely, some patients exhibit masked hypertension at office visits: blood pressure that is normal in a clinic setting, but above normal in other settings.
For proper hypertension management, patients should take their blood pressure at home. However, this can be an onerous task and one that can be done incorrectly because of the many steps involved. For a proper home blood pressure reading, patients should:
- Rest comfortably for 5 minutes in a seated position with back support.
- Arm should be bare and supported with the blood pressure cuff at heart level.
- Not consume caffeine or tobacco in the hour before taking the measurement.
- Not exercise 30 minutes before taking the measurement.
- Take measurements before breakfast and 2 hours after dinner.
- Take measurements before taking medication.
- Take two measurements in the morning and two in the evening on a regular basis, ideally daily.
It can be challenging to remember all these steps. Patients that do check their blood pressure regularly at home sometimes forget a step leading to an inaccurate reading.
Patients often use many different methods for their blood pressure diary. Healthcare providers may be handed pencil and paper sheets, sent Excel files, or a variety of other forms of blood pressure logs. This leaves the healthcare provider with additional work to review the readings, ensure their patients have taken their blood pressure regularly, and calculate that they have accurately averaged their results. The variety of different blood pressure diaries means the healthcare provider is shuffling between different files – something sent electronically, additional paper for medical files, or having electronic files that the healthcare provider does not have the software to read. Management of these logs adds to healthcare provider burnout.
Without a streamlined and simple way to review home blood pressure and office readings, it can be challenging for the primary healthcare provider to manage their hypertension patients. Reviewing these readings informs the healthcare provider if their patients are meeting their blood pressure targets, to know when a follow-up appointment is required, and to understand when the treatment plan needs to be altered.
Hypertension increases substantially with age, and as our elderly proportion of the population is growing rapidly, the management of this group of patients deserves considerable attention. We need a method to help not only our hypertension patients manage their blood pressure, but also a method that helps the healthcare provider effectively and easily manage their disease.
BProactive Makes Treatment of Hypertension Patients Easier
BProactive is a mobile medical app that is designed with both the needs of the patient and healthcare provider in mind.
For the patient, the BProactive app will provide prompts on when to take blood pressure. It will also guide the patients on the correct way to take blood pressure readings, eliminating inaccurate readings from poor procedure.
For the healthcare provider, patient blood pressure readings are sent directly to one easy-to-use and streamlined web portal via a cloud service, removing the multiple ways that patients complete their blood pressure logs. This portal, designed by healthcare providers for healthcare providers, allows for straight-forward review of patient progress. It provides an area for the healthcare provider to enter the patient’s current medication. It will also constantly analyze patient blood pressure readings and alert the healthcare provider when a patient is not meeting their targets and that a follow-up assessment is required.
Some clinics using BProactive employ a team of Interdisciplinary Health Professionals. An IHP such as an RN, Nurse Practitioner, or Pharmacist monitors follow-up notifications from BProactive and consults with the Care Lead as needed to make treatment recommendations. Employing the resources already available at many primary healthcare provider clinics, in conjunction with BProactive, can result in better blood pressure control in hypertensive patients while being less burdensome on both patients and practitioners.
Want to Learn More?
Interested in learning how BProactive can help you and your patients connect? Sign up for a free clinic account today! Visit: https://unboxedhealth.com/
Ian MacDonald, M.D., FRCPC (Nephrology)
Chief Medical Officer
Unboxed Health Inc.
Dr. Ian MacDonald is a practising Nephrologist in Northern Ontario, with an interest in Hypertension.