Treat uncontrolled high blood pressure

Owned by Dave Carlson
Last updated: Sept 28, 2020
1 min read

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