- A study suggests that a standardized, stepwise treatment tool integrated into electronic health records, could help to improve blood pressure control.
- This system-wide hypertension program could translate into major health benefits, such as preventing strokes, heart attacks, and deaths.
- However, while outcomes improved across populations, disparities remained, highlighting the need for targeted interventions.
Hypertension, or high blood pressure, affects almost half of the United States adult population, with prevalence rising with age and surpassing
However, only about 1 in 4 adults living with hypertension have their blood pressure well-controlled, indicating a high burden of uncontrolled cases.
A recent study, published in BMJ Open Quality, highlights a system-wide hypertension program implemented across the University of California Health network, which has significantly improved blood pressure control and prevented serious cardiovascular events
Led by researchers at the University of California, San Francisco (UCSF), the 2-year study evaluated outcomes among roughly 90,000 participants treated across 6 academic medical centers.
The development of the tool involved a multidisciplinary team, including cardiologists, internists, primary care physicians, nurses, pharmacists, and data scientists.
Lead author Sandeep Kishore, MD, PhD, an internist and associate professor of medicine at UCSF who specializes in cardiometabolic health told Medical News Today about the intent behind the study:
“Our goal was to make best practice the everyday practice. Even in a complex, decentralized system, you can reduce care variations at scale — if you keep the approach simple, affordable, and flexible.”
The intervention, known as the UC Way Hypertension Medication Algorithm, is a standardized yet flexible treatment framework integrated into electronic health records.
The researchers suggest it can guide clinicians through stepwise medication adjustments while allowing them to adjust treatment based on personalized factors such as age and comorbidities.
The tool was implemented systemwide in 2023, and the findings note that the proportion of patients with controlled hypertension increased from 68.5% to nearly 74% by mid-2025.
The research team suggests this improvement amounts to about 4,860 people, and helped avoid roughly 72 strokes, 48 heart attacks, and 38 deaths, according to a press release.
Kishore added that, in real-world terms, these numbers represent Californians who did not end up in an emergency room, did not have a disability, and did not miss time with their family.
The multidisciplinary group began meeting in 2020 to create a comprehensive strategy that emphasized medication affordability and reducing treatment variation across diverse populations.
Although the algorithm focuses on medication management, researchers stressed the importance of lifestyle changes alongside clinical treatment.
Recommendations to improve blood pressure include quitting smoking, limiting alcohol consumption, reducing sodium intake, increasing physical activity, managing weight, following a healthy dietary plan, and regularly using at-home blood pressure monitors.
Only about half of individuals with hypertension report taking medication to lower their blood pressure, and roughly
The study also examined outcomes across different populations. While improvements were seen broadly, disparities persisted.
Among Black participants, blood pressure control increased from 63.4% to 67.3%. However, researchers noted that hypertension remains more prevalent and severe in this group.
Estimates suggest that by age 55, about 75% of Black adults will develop hypertension, compared with lower rates among white populations.
The authors emphasized that while standardized care models can improve overall outcomes, targeted interventions remain necessary to close persistent gaps.
With more than 9 million outpatient visits annually, the University of California Health system represents one of the largest public academic healthcare networks in the U.S.
Researchers suggest that the UC Way model could be adapted by other health systems or expanded to manage additional chronic diseases.
Kishore told MNT, “The evidence is clear and UC Health shows it in practice: a systems-based approach, combining a clear protocol, team-based care, and real-world data systems, is what moves the needle.”
The findings indicate that coordinated, large-scale interventions embedded into routine clinical workflows could deliver measurable improvements in population health. This could help to reduce the burden of preventable cardiovascular disease, which is forecast to
Additionally, the researchers note that efforts are already underway to apply similar approaches to diabetes care.
