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Blood Pressure Management
5.4. Plan of Care for Hypertension
COR LOE
Recommendations
Team-Based Care
1 A
1. For adults with uncontrolled hypertension, a team-based care
approach is recommended to achieve and maintain BP control.
1 C-LD
2. For adults with uncontrolled hypertension, an evidence-
based care plan utilizing HBPM, and team-based care that is
responsive to addressing adverse SDOH, is recommended to
achieve and maintain BP control.
Framework in Clinical Practice to Improve Hypertension Control
1 B-NR
3. For adults with uncontrolled hypertension, an integrated
treatment model that includes accurate BP measurement,
prompt treatment, patient engagement, and ongoing review
of HBPM is recommended to improve BP control.
Follow-Up Aer Initial BP Evaluation and Initiation of Antihypertensive erapy
1 B-R
4. Adults with uncontrolled hypertension placed on new or
intensified medical therapy should have follow-up evaluations
for medication adherence and response to treatment at
monthly intervals until control is achieved.
Health Information Technology
1 B-R
5. For adults with uncontrolled hypertension, health
information technolog y (HIT) by synchronous (eg, phone,
video call) or asynchronous (eg, text, email) communication
is beneficial in improving BP control, access to care, and
adherence to standards of care and should be incorporated in
the management of hypertension, including the titration of
BP medications.
1 B-NR
6. In adults with undiagnosed or uncontrolled hypertension, use
of the electronic health record (EHR) and patient registries is
beneficial for screening and identification of hypertension to
focus on those who need additional care.
2a B-R
7. In adults with uncontrolled hypertension, telehealth
interventions can be useful to reduce BP and improve office
BP control.