May 3, 2022
May is National High Blood Pressure Education Month
According to the CDC (Facts About Hypertension, 2021):
- Almost half of the adults in the United States have hypertension or are taking medications for hypertension.
- In 2019, over a half million deaths in the United States were linked to hypertension.
- There is a higher incidence of hypertension in non-Hispanic black adults as compared to non-Hispanic white adults, non-Hispanic Asian adults, or Hispanic adults.
- Only one in four adults with hypertension have it under control.
- Higher blood pressure levels may put the patient at risk for cardiovascular disease.
May is National Blood Pressure Education Month. This month focuses on teaching the community about the importance of screening, diagnosing, and early treatment of high blood pressure.
Hypertension can be classified as either primary or secondary.
- With primary hypertension, the cause is unknown. This type of hypertension develops slowly over time.
- Secondary hypertension is caused by another pre-existing condition. This type develops suddenly. Patients with secondary hypertension tend to present with higher blood pressure readings than those with primary hypertension.
Signs and Symptoms
- Frequently, people with high blood pressure do not initially present with any signs or symptoms. Patients often are only aware after measuring their blood pressure at a doctor visit.
- Patients may present with signs and symptoms such as headache, nosebleed, and shortness of breath. These can be an indication of a severe or life-threatening blood pressure level.
- Complications from elevated blood pressure or hypertension include, but are not limited to heart failure, cerebrovascular accidents/transient ischemic attacks, myocardial infractions, aneurysms, kidney damage, retinopathy, peripheral arterial disease (PAD), and cognitive impairment.
Risk factors
- Though we can’t control the nonmodifiable risk factors, such as age, race, and family history, lifestyle modifications can help with controlling the modifiable risk factors, such as being overweight, lack of physical activity, poor diet, alcohol use, and smoking.
Screening/Treatment
- Measurement of a patient’s blood pressure is one of the required components of the Initial Preventive Physical Exam (IPPE) and the Annual Wellness Visit (AWV). Regular monitoring of the blood pressure can assist with diagnosing high blood pressure as well determining the best treatment plan.
- Those with diabetes should also be monitored for elevated blood pressure. Per the CDC, around six of every ten diabetics have high blood pressure (Manage High Blood Pressure | cdc.gov, 2020).
- Lifestyle changes such as exercise, smoking cessation, healthy diet, and weight management can facilitate the lowering of blood pressure. If lifestyle changes do not work, antihypertensive medications may be ordered.
Prevention
You can assist patients with managing elevated blood pressure and hypertension.
- Blood pressure measurement is a component of the IPPE and AWV. Encourage your patients to schedule these preventive visits.
- Talk to your patients about heart health including risk factors for hypertension.
- Educate your patients on healthy habits such as exercising, eating a well-balanced diet including foods that are low in salt, fat, and cholesterol, lowering stress levels, controlling weight (or losing weight if needed), and getting enough sleep.
- Encourage your patients to refrain from or to limit use of alcohol. Discuss with your patients the link between alcohol use and risk for hypertension.
- Monitor your patients’ blood pressure levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood pressure and cardiovascular disease.
- If your patients have a home blood pressure monitor, teach them how to use this device to monitor their blood pressures as well as when and how to report readings.
- If your patients are diabetic, monitor their blood glucose levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood glucose levels and elevated blood pressure.
- If your patients are currently on antihypertensive medications, review the importance of regularly taking medications. Address any questions they may have regarding the medications prescribed.
- Encourage your patients to quit smoking. Instruct your patients on the effects of smoking and the link between smoking and risk for cardiovascular disease. Medicare covers counseling to prevent tobacco use for those patients that qualify. Discuss this Medicare covered benefit with your patients and encourage them to enroll.
- Medicare covers Cardiovascular Disease Screening Test, Intensive Behavioral Therapy (IBT) for Cardiovascular Disease, and Intensive Behavioral Therapy (IBT) for Obesity for those patients that qualify. Discuss this Medicare covered benefits with your patients and encourage them to enroll if applicable.
To learn more about Medicare-covered services, visit CMS Preventive Services
- Initial Preventive Physical Exam (IPPE)
- Annual Wellness Visit (AWV)
- Cardiovascular Disease Screening Tests
- Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD)
- Intensive Behavioral Therapy (IBT) for Obesity
- Counseling to Prevent Tobacco Use
- Alcohol Misuse Screening & Counseling
- Ultrasound Abdominal Aortic Aneurysm (AAA) Screening
- Diabetes Screening
- Medical Nutrition Therapy (MNT)
- Diabetes Self-Management Training (DSMT)
For More Information
CMS.gov and Medicare.gov Resources
- National Coverage Determination (NCD) for Intensive Behavioral Therapy for Cardiovascular Disease (210.11) (cms.gov)
- National Coverage Determination (NCD) for Intensive Behavioral Therapy for Obesity (210.12) (cms.gov)
- National Coverage Determination (NCD) for Counseling to Prevent Tobacco Use (210.4.1) (cms.gov)
- NCD - Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse (210.8) (cms.gov)
- National Coverage Determination (NCD) for Diabetes Outpatient Self-Management Training (40.1) (cms.gov)
- National Coverage Determination (NCD) for Medical Nutrition Therapy (180.1) (cms.gov)
- MLN Educational Tool February 2021 Updates Medicare Wellness Visits
- Preventive & Screening Services (medicare.gov)
Other Resources
- High Blood Pressure | cdc.gov
- Million Hearts® (hhs.gov)
- High Blood Pressure | American Heart Association
- High Blood Pressure Symptoms and Causes | cdc.gov.
- High blood pressure (hypertension) - Symptoms and causes - Mayo Clinic
- High blood pressure dangers: Hypertension's effects on your body - Mayo Clinic
- Know Your Risk for High Blood Pressure | cdc.gov
- Measure Your Blood Pressure | cdc.gov
- Blood Pressure Medicines | cdc.gov
- Hypertension and Diabetes Mellitus | Hypertension (ahajournals.org)
- Type 2 diabetes mellitus and hypertension: An update (nih.gov)
- National Blood Pressure Month (nationaltoday.com)
References
- Facts About Hypertension. (2021, September 27). www.cms.gov. https://www.cdc.gov/bloodpressure/facts.htm
- High Blood Pressure Dangers: Hypertension’s Effects on Your Body. (2019, November 19). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868
- High Blood Pressure Symptoms and Causes. (2021, May 18). Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/about.htm
- Know Your Risk for High Blood Pressure. (2020, February 24). Centers for Disease Control and Prevention.. https://www.cdc.gov/bloodpressure/risk_factors.htm
- Prevent and Manage High Blood Pressure. (2020, September 30). Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/prevent_manage.htm