Multilevel Strategy Works Best for Blood Pressure Control: It's a Team Sport

Blood pressure (BP) goals are achieved in less than half of patients who receive antihypertensive drug therapy, and that success rate has remained unchanged for 4 decades. In this meta-analysis of 100 randomized, controlled trials, researchers compared the effectiveness of various implementation strategies for achieving BP control in nearly 56,000 adults with hypertension.

The most-effective BP-lowering strategies incorporated multiple interventions, and teams where nonphysicians (i.e., nurses, pharmacists, medical assistants, or community health workers) titrated medications were most effective (average systolic BP [SBP] lowering, 7 mm Hg), followed by teams where physicians titrated medications (average SBP lowering, 6 mm Hg). Other multip…