Report Shows Pharmacists Play a Critical Role in Blood Pressure Management

Pharmacists and community health care workers (CHW) have the best success when helping patients with high blood pressure (BP), according to investigators from Tulane University who published their research in Circulation: Cardiovascular Quality and Outcomes. Their findings showed that pharmacist-led interventions resulted in the greatest systolic BP reductions, underscoring their significant role in BP management for patients with hypertension.

The report emphasizes the critical role that pharmacists play in managing hypertension, highlighting their unique position and accessibility to patients. Image Credit: © grinny - stock.adobe.com

Hypertension is the leading preventable cause of early death, affecting nearly 31.1% of individuals worldwide and is a significant risk factor for cardiovascular disease (CVD). Despite the proven effectiveness of medical and lifestyle modification interventions, only 13.8% of patients with hypertension have their BP under control. This is due to the barriers to effective BP control evident at every level of medicine, from patients, to providers, to the health care system at large. For example, primary care physicians often lack the available time to provide comprehensive medication titration and lifestyle modification counseling, which can greatly impact a patient’s understanding of and adherence to treatment.¹

The study authors emphasize the role of team-based care and task shifting as a strategy to overcome the gap in care for patients with hypertension. This can include assigning health coaching and medication titration to pharmacists, CHWs, nurses, and health educators to open pathways to effective treatment management for patients.¹

The authors’ findings indicate that hypertension is best treated by health care professionals who have more availability to offer to patients. They conducted a meta-analysis of randomized controlled trials that characterized interventions based on the type of health care professional leading the treatment, including nurses, physicians, health educators (such as dieticians), CHWs, and pharmacists. The analysis included 100 articles with 90,474 patients and 116 comparisons.¹

The results showed that pharmacist-led treatment management reduced systolic BP by 7.3 mmHg (95% CI, −9.1 to −5.6). Additionally, CHW-led interventions demonstrated a decrease of 7.1 mmHg (95% CI, −10.8 to −3.4) and health educators saw a reduction of 5.2 mmHg (95% CI, −7.8 to −2.6). Health care professional- (HCP), physician-, and nurse-led interventions also saw significant reductions of 4.2 mmHg (95% CI, −6.1 to −2.4), 3.0 mmHg (95% CI, 4.2 to −1.9), and 2.4 mmHg (95% CI, −3.4 to −1.5) mmHg, respectively. The findings offer evidence that all HCPs are capable of providing effective interventions for patients with hypertension, but involvement in management of BP had the greatest impact on treatment.¹

The Tulane investigators also emphasized the critical role that pharmacists play in managing hypertension in particular, highlighting their unique position and accessibility to patients. By integrating pharmacists more deeply into care teams, they can provide patients with extensive knowledge of medication management and personalized care, effectively bridging the treatment gap for patients with hypertension. With the help of pharmacists, the burden of hypertension can be reduced to limit risk of CVD and improve patients’ quality of life.

“This study underscores the importance of a team-based care approach to helping keep [BP] under control,” said Lawrence J. Fine, MD, a senior advisor in the clinical applications and prevention branch in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute, in a press release. “In addition to traditional health care providers like physicians, other team members such as pharmacists and [CHWs] can be effective in helping individuals achieve their treatment goals, particularly when [BP] control has declined nationwide in recent years.”²

REFERENCES

1. Mills K, O’Connell S, Pan M, et al. Role of health care professionals in the success of blood pressure control interventions in patients with hypertension: a meta-analysis. Circ Cardiovasc Qual Outcomes. July 19, 2024. doi: 10.1161/CIRCOUTCOMES.123.010396
2. These healthcare professionals may be secret weapon against hypertension, study says. News Release. July 19, 2024. Accessed July 19, 2024. https://www.eurekalert.org/news-releases/1051605