Success Story: Five Health Care Organizations Address Hypertension-Related Health Disparities
Kelsey-Seybold Clinic (Houston, Texas); Green Spring Internal Medicine in (Lutherville, Maryland); Denver Health Community Health Services; Kaiser Permanente Southern California; and Northlake Family Medical Practice (Columbia, South Carolina) (2014)
In previous rounds of the Hypertension Control Challenge, Million Hearts® established a benchmark of 70% hypertension control for applicants’ adult populations. This 2014 success story reflects the earlier benchmark.
In 2014, Million Hearts® recognized 30 health care organizations and practices as 2014 Hypertension Control Champions for controlling the blood pressure of at least 70% of their hypertensive patients. Five of these Champions—Kelsey-Seybold Clinic in Houston, Texas; Green Spring Internal Medicine in Lutherville, Maryland; Denver Health Community Health Services; Kaiser Permanente Southern California; and Northlake Family Medical Practice in Columbia, South Carolina—also have many patients from racial and ethnic minority groups who have a higher risk for hypertension (high blood pressure) or who are less likely to receive treatment.
African Americans have a much higher risk of having high blood pressure. About 33% of all adults have hypertension, but about 45% of African Americans do. Hispanics do not have higher rates of hypertension, but Hispanic men who are hypertensive are less likely to take blood pressure medication.
Support from the Top
Kelsey-Seybold has locations across Houston and a patient population that is about 19% African American, 15% Hispanic, and 6% Asian, Native Hawaiian, or Pacific Islander.
As part of providing the best care and reducing health disparities, the clinic has a Spanish-language website and doctors and staff who are bilingual in English and Spanish. The clinic also has a language line available to meet the language needs of non-English speakers when a staff member is unavailable.
The clinic also has a physician who is a hypertension specialist and a strong advocate for the hypertension control effort across the clinics. Among other steps, the hypertension specialist has emphasized the importance of proper techniques for measuring blood pressure through education and training.
A Symptom of Stress
Hypertension is a medical problem, and stress may lead to temporary increases in blood pressure. At Green Spring Internal Medicine, Holly R. Dahlman, MD, takes the time to talk with her patients about why they are having difficulty controlling their hypertension and acknowledges the source of the patient’s stress and the role stress can play in the patient’s health.
At Denver Health, 78% of the patients are racial or ethnic minorities, including 33% whose primary language is not English. Denver Health uses community-based prevention programs to reach minority groups, including a community health worker (promotora)–led prevention program for Latino patients. Denver Health also runs the Just Check It blood pressure control program in collaboration with the Center for African American Health.
Kaiser found that their medication protocol was not strong enough for many of their African American patients. By doubling the dose for those patients, Kaiser was able to reduce the blood pressure to safe levels. Those steps and others have helped to achieve more equitable outcomes in controlling the blood pressure of their African American patients.
Lifestyle Is the Key
At Northlake, 96% of patients are African American, a population that is at greater risk for hypertension. Reginald Parker, MD, a solo practitioner, advises his patients to follow the DASH eating plan, which encourages lower sodium consumption and emphasizes fresh fruits and vegetables.
To help his patients really understand hypertension, Dr. Parker uses educational resources such as visuals of the heart and blood vessels, and he reinforces his advice with informational flyers.
These five providers have made control for every single patient their goal in the face of health disparities that put some populations at greater risk. These and other practices show that it is possible to maintain high rates of hypertension control among their patients.