Treat uncontrolled high blood pressure
This Hypertension treatment scenario is excerpted from Intermountain Healthcare’s Management of High Blood Pressure guideline and will be used to create targeted examples that illustrate recommended use of standards, as described in the Hypertension Use Case. See also:
Preconditions
Patient has diagnosis of Hypertension on active problem list
Select using value set with SNOMED CT and ICD-10 codes
Patient is not pregnant
Patient does not have active prescription for ACE-I or ARB
Most recent BP within last 4 weeks is:
> 140/90 if patient has CKD and/or Diabetes comorbidity
> 130/80 otherwise
NOTE: these are not complete guideline criteria, but serve to illustrate implementation approaches.
Treatment Recommendations
Initiate treatment with ACE-I (or ARB): lisinopril (or losartan)
Lisinopril, 10mg daily
Rapid cycle: Evaluate BP every two weeks while titrating or switching meds.
Increase to Lisinopril, 20mg daily if BP is not within management target.
Referenced Value Sets
ACE-I and ARB RxNorm codes
Diagnosis of Hypertension
Chronic Kidney Disease All Stages (1 through 5)
Diabetes
TBD