Prevention and Control of Hypertension: JACC Health Promotion Series

J Am Coll Cardiol. 2018 Sep 11;72(11):1278-1293. doi: 10.1016/j.jacc.2018.07.008.


Hypertension, the leading risk factor for cardiovascular disease, originates from combined genetic, environmental, and social determinants. Environmental factors include overweight/obesity, unhealthy diet, excessive dietary sodium, inadequate dietary potassium, insufficient physical activity, and consumption of alcohol. Prevention and control of hypertension can be achieved through targeted and/or population-based strategies. For control of hypertension, the targeted strategy involves interventions to increase awareness, treatment, and control in individuals. Corresponding population-based strategies involve interventions designed to achieve a small reduction in blood pressure (BP) in the entire population. Having a usual source of care, optimizing adherence, and minimizing therapeutic inertia are associated with higher rates of BP control. The Chronic Care Model, a collaborative partnership among the patient, provider, and health system, incorporates a multilevel approach for control of hypertension. Optimizing the prevention, recognition, and care of hypertension requires a paradigm shift to team-based care and the use of strategies known to control BP.

Keywords: antihypertensive agents; dietary sodium; exercise; lifestyle; medication adherence; telemedicine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure Monitoring, Ambulatory
  • Diet
  • Exercise
  • Genetic Predisposition to Disease
  • Health Knowledge, Attitudes, Practice
  • Health Policy
  • Health Promotion
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / etiology
  • Hypertension / therapy*
  • Life Style
  • Models, Organizational
  • Overweight / complications
  • Overweight / prevention & control
  • Patient Care Team
  • Patient Compliance
  • Potassium, Dietary / administration & dosage
  • Social Determinants of Health
  • Sodium, Dietary / administration & dosage
  • Sodium, Dietary / adverse effects
  • Telemedicine


  • Antihypertensive Agents
  • Potassium, Dietary
  • Sodium, Dietary