National High Blood Pressure Education Program
PROGRAM DESCRIPTION
Origin and Purpose
The National High Blood Pressure Education Program
(NHBPEP), established in 1972, is a cooperative effort among professional and
voluntary health agencies, state health departments, and many community groups.
The NHBPEP is coordinated by the National Heart, Lung, and Blood Institute
(NHLBI) of the National Institutes of Health.
The goal of the NHBPEP is to reduce death and
disability related to high blood pressure through programs of professional,
patient, and public education. The NHBPEP also strives to achieve the heart
disease and stroke Healthy People 2010 objectives for the Nation. Strategies to
achieve the program goal include developing and disseminating stimulating
educational materials and programs that are grounded in a strong science base
as well as developing partnerships among the program participants.
Partnerships
Throughout its history, the NHBPEP has employed a
comprehensive strategy to mobilize, educate, and coordinate resources of groups
interested in hypertension prevention and control. The NHBPEP is comprised of a
network of Federal agencies, voluntary and professional organizations, state
health departments, and numerous community-based programs. At the core of the
program is the NHBPEP Coordinating Committee, composed of representatives from
38 national professional, public, and voluntary health organizations and 7
Federal agencies.
The NHBPEP follows a consensus-building process to
identify major issues of concern and to develop program activities. As part of
this approach, representatives from the NHBPEP Coordinating Committee member
organizations work together to provide guidance to the program and each other
as well as to develop and promote educational activities through their own
constituencies. This multidisciplinary committee also defines national
priorities for the NHBPEP, examines critical issues, explores future
opportunities, sponsors national activities, and promotes collaboration among
the many organizations involved in the prevention, detection, treatment, and
control of high blood pressure.
The partnership encompasses a wide distribution
network supporting a mass media effort and the distribution of professional,
patient, and public education materials and documents. Among publications
developed and distributed are fact sheets, pamphlets, and brochures dealing
with lifestyle changes, planning kits to stimulate program activities, posters,
print ads, radio messages, and working group reports. One consensus document,
the Report of the Joint National Committee on Detection, Evaluation, and
Treatment of High Blood Pressure (JNC), first published in 1976, has had
five subsequent updates. The JNC reports serve as guidelines for clinicians and
community groups. The reports have been distributed to all state health
departments, nearly every primary care clinician and all hypertension control
programs in the Nation, and they have been translated into foreign languages as
well.
Issues and Scope
The NHBPEP represents a wide range of perspectives.
Major hypertension control issues examined by the program encompass these
items:
- Excessive stroke mortality in the southeastern
United States
- Effective treatment practices
- Utility of lowering the systolic blood pressure in
older Americans
- Role of lifestyle changes in preventing and
treating hypertension
- Population-based strategies for primary prevention
of high blood pressure
- Issues regarding special populations and situations
(e.g., African Americans, renal disease, women, children, and adolescents)
- Educational strategies directed at professional,
patient, and public audiences, and community organizations
- Development and support of HEDIS hypertension
measures
Supporting Services
To assist program participants in carrying out their
diverse efforts, the NHBPEP offers resources in several major areas:
- Information Collection and DisseminationThe
NHLBI Health Information Network is a source of hypertension-related
information for consumers, health professionals, and planners. Network services
include response to inquiries, collection and dissemination of information and
education materials, and production of program bulletins to inform health
professionals about NHLBI activities.
- Public, Patient, and Professional
EducationThe NHBPEP develops and maintains an inventory of program
materials for consumers, patients, and professionals, which include pamphlets
for patients and consumers, posters, and a catalog of NHLBI materials. In
addition, the NHBPEP distributes recommendations for managing high blood
pressure, and professional educational materials.
- Community Program DevelopmentThe NHBPEP
offers limited help in developing and evaluating community programs using
established local resources. The staff maintains liaisons with state health
departments and community organizations. Assistance also is provided in
planning continuing education programs, workshops, and regional conferences.
- Evaluation and Data AnalysisThe NHBPEP
identifies and evaluates the results of major studies; provides data analysis
information and technical assistance to health professionals in the field;
assists in planning, conducting, and evaluating special studies; and identifies
and provides potential new sources of data for assessing progress in
hypertension prevention and control.
- Technology Transfer and Electronic
DistributionThe NHBPEP makes its documents available on the Internet.
Working group reports, coordinating committee rosters, summaries of the NHBPEP
Coordinating Committee meetings, and program announcements may be accessed for
viewing and downloading. The NHBPEP can be accessed through the NHLBI home page
at http://www.nhlbi.nih.gov.
Progress
The effectiveness of the NHBPEP can be measured in
several ways. Public knowledge regarding the sequelae of high blood pressure
has increased dramatically. For example, in 1972, the year the program began,
less than one-fourth of the American population knew of the relationship
between hypertension and stroke and hypertension and heart disease. Today, more
than three-fourths of the population know of that relationship. In addition,
the Nation's population has received the message to get their blood pressure
measured. Virtually all Americans have had their blood pressure measured at
least once, and three-fourths of the population have it measured every 6
months.
In the last 2 decades, the number of persons with
hypertension who are aware of their condition has increased dramatically. In
addition, the percentage of persons with hypertension who are on medication and
controlling their condition also has improved substantially (table 1), but
recent data indicate this trend is subsiding, a new program concern.
Table 1
Mean blood pressures compared in four national health
surveys conducted between 1960 and 1991 suggest a reduction of 10 mm Hg
systolic pressure and 5 mm Hg diastolic pressure during this time period. These
remarkable decreases indicate that the U.S. population has heard and acted upon
NHBPEP messages. More importantly, this significant reduction in mean blood
pressures has had a significant effect on death rates from heart disease and
stroke.
Because uncontrolled high blood pressure is a major
risk factor for stroke and coronary heart disease (CHD), the changing mortality
rate for cardiovascular events is another indication of NHBPEP progress. The
age-adjusted mortality rate for stroke and CHD has declined nearly 60 and 53
percent, respectively (figure 2). The decline is real and can be observed for
men, women, whites, and African Americans. This decline can be attributed in
part to improved hypertension control, and it is evident in women and men as
well as in African Americans and whites.
Figure 1
Figure 2
CHD and stroke, two of the major complications of
untreated hypertension, are still the first and third causes of death,
respectively, in the United States. From 1972 to 1994, the mortality rate from
CHD per 100,000 declined from 195.4 to 92.4. During that same time period, the
mortality rate from stroke per 100,000 declined from 64.6 to 26.7. These
decreases are impressive and represent many tens of thousands of lives saved in
20 years. However, much remains to be done. The NHBPEP, using its extensive
network and partnerships, is focusing its efforts so that this important public
health problem continues to be addressed and progress will continue into the
next decade.
Year 2010 Goals
In January 2000, the Department of Health and Human
Services launched Healthy People 2010, a national health promotion and disease
prevention initiative that brings together national, state, and local
government agencies; nonprofit, voluntary, and professional organizations;
businesses; communities; and individuals to improve the health of all
Americans, eliminate disparities in health, and improve years and quality of
healthy life. The NHBPEP has adopted the Healthy People 2010 goals that address
reductions in hypertension-related mortality rates. Table 2 lists the goals and
progress toward meeting them.
Table 2
NHBPEP Coordinating Committee Member Organizations
American Academy of Family Physicians American Academy of Insurance
Medicine American Academy of Neurology American Academy of
Ophthalmology American Academy of Physician Assistants American
Association of Occupational Health Nurses American College of
Cardiology American College of Chest Physicians American College of
Occupational and Environmental Medicine American College of Physicians
American College of Preventive Medicine American Dental Association
American Diabetes Association American Dietetic Association American
Heart Association American Hospital Association American Medical
Association American Nurses Association American Optometric
Association American Osteopathic Association American Pharmaceutical
Association American Podiatric Medical Association American Public
Health Association American Red Cross American Society of Health-System
Pharmacists American Society of Hypertension Association of Black
Cardiologists Citizens for Public Action on High Blood Pressure and
Cholesterol, Inc. Council on Geriatric Cardiology International Society
on Hypertension in Blacks National Black Nurses' Association, Inc.
National Hypertension Association, Inc. National Kidney Foundation,
Inc. National Medical Association National Optometric Association
National Stroke Association Society for Nutrition Education
Federal Agencies
Agency for Healthcare Research and Quality Health
Care Financing Administration Health Resources and Services
Administration National Center for Health Statistics, Centers for
Disease Control and Prevention National Heart, Lung, and Blood
Institute National Institute of Diabetes and Digestive and Kidney
Diseases NHLBI Ad Hoc Committee on Minority Populations
For more information about the NHBPEP, contact:
National High Blood Pressure Education Program
NHLBI Health Information Center P.O. Box 30105 Bethesda, Maryland
20824-0105 (301) 592-8573 phone (301) 592-8563 fax
http://www.nhlbi.nih.gov
|