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Table 19. Responsibilities and Roles of the Hypertension
Team
Hypertension Team Responsibilities
Communication, shared decision-making, and care coordination among various clinical
team members, the patient, and patient caregivers
Effective use of evidence-based diagnosis and management guidelines
Regular, structured follow-up mechanisms and reminder systems to monitor patient progress
Medication adherence support and patient education about hypertension medication
Medication initiation, addition, and titration using evidence-based treatment algorithms
Use of evidence-based tools and resources designed to maximize self-management
(including health behavior change, lifestyle modification, etc.)
Individual Hypertension
Team Members Roles (examples)
Primary Care Physician/Cardiologist,
Physician Assistant or Associate/Nurse
Practitioner/Advanced Practice Nurse
Routine and complex hypertension care,
managing primary care issues
Cardiologist/Physician Assistant or
Associate/Nurse Practitioner/Advanced
Practice Nurse
Routine and complex hypertension care,
especially for patients with cardiac disease or
high risk for major cardiovascular events
Nephrologist, Endocrinologist,
Hypertension Specialist
Management of complex hypertension care,
especially due to secondary causes, and/or
resistant hypertension
Nurse (including in-office, home care,
internal and external population health
personnel)
Accurate assessment of BP, medication
reconciliation, patient education, self-
management, lifestyle modification, and
adherence
Clinical Pharmacist Comprehensive medication management,
identification of medication-related
interactions, and educating patients on their
medication regimen
Dietician Ongoing patient-centered counseling to
assess dietary habits and preferences and set
and monitor goals for healthy lifestyle
Social Worker Assess for psychosocial, cultural, and
financial barriers and find solutions to
overcome these barriers
Community Health Worker Assess and address social determinants of
health and identify and promote acceptable
community-based resources to overcome
these barriers
