Hypertension is a major public health challenge, given the high prevalence of more than 30% in US adults and the increased risk of coronary heart disease, stroke, and end – stage renal disease with subsequent death. In New York City, little progress has been made in the control of blood pressure in adults with hypertension or the prevention of high blood pressure in recent years. Additionally, minority populations and very poor neighborhoods have a higher prevalence of hypertension and less well - controlled hypertension when treated.
In this context, the NYC Department of Health and Mental Health (DOHMH) has launched a citywide high blood pressure initiative, called Take the Pressure Off, NYC! (TPO,NYC!). NYACP asked Susan Urban, MD, FACP, to join the first coalition meeting of more than 100 participants across 13 sectors which took place March 2017, and to monitor and report on activities.
At the first coalition meeting, the citywide initiative set up three working groups to address some of the barriers to adequate control of high blood pressure: an Awareness group (whose goal is to increase awareness), a Heart Healthy Behaviors group (whose goal is to support healthy diet and physical activity through the environment), and a Treatment Adherence group (whose goal is to increase medication adherence and health behavior modification such as decreased salt in the diet). Two other groups started later: a Strategic Payer Initiative group to address possible health-insurance –related barriers and a Monitoring and Metrics group for following the progress.
A summit was held October 10, 2018 which included a summary of the work done to date. The two awareness subgroups have developed a resource library from materials submitted by coalition members. An NYC Health Map was created, which shows where in the community patients can check their blood pressures, and a calendar suggesting dates and subjects for hypertension social media messaging. The treatment adherence group is also working on facilitating out - of - office blood pressure readings for patients already diagnosed with hypertension. This work fits well with recent guideline recommendations for out-of-office blood pressure measurements both for diagnosis and for monitoring of treated hypertension.
Currently, a Manhattan district meeting is being planned in which the Take the Pressure Off, NYC! Initiative director will highlight their HTN Action Kit containing information for clinicians to use with patients. In the year ahead, the Chapter will continue its collaboration with the Initiative and coalition members, working towards a shared goal of prevention and adequate treatment of high blood pressure, and ultimately a decrease in premature mortality and morbidity.