NHBPEP Coordinating Committee Background Paper

Next year, the National High Blood Pressure Education Program (NHBPEP) will celebrate its 30th anniversary. During the past three decades, the Coordinating Committee (CC) has produced, conducted, and implemented many activities to improve prevention and control of high blood pressure. The CC is a cohesive body which meets on a regular basis. Attendance remains high, if not perfect, at most meetings. The CC continues to monitor the science and use available information to set national policy. The science has driven several program paradigm shifts. Among these are: lowering the hypertension threshold from 165/95 to 140/90; recommending treatment for so-called mild hypertension and systolic blood pressure in older Americans; identifying the need for and how to prevent hypertension; developing a position on the upper limits of dietary sodium intake; and developing guidelines on high blood pressure management for the public health and clinical communities.

The CC has accomplished much. The process and infrastructure used by the CC have been replicated by national education programs on high blood cholesterol, asthma prevention and control, heart attack alert, diabetes prevention and control, eye diseases, kidney diseases, and lupus. After 30 years of committee activity, the public's awareness of hypertension has increased, treatment rates have improved substantially, hypertension control rates have improved significantly, and age-adjusted stroke and coronary heart disease mortality have declined. The program has demonstrated that when efforts are concentrated, as in the Southeast, stroke mortality will decline. When efforts are targeted to specific populations, such as African Americans, control rates will improve and disparity gaps will decrease. Many clinicians do not establish goal blood pressure in patients. Others fail to treat or to achieve the goal. Public health approaches to prevention are neglected or applied sparingly. Guidelines are prepared, yet not uniformly applied. Many of the Program's activities, such as High Blood Pressure Education Month, are not fully used.

Given all this, the CC is asked to discuss the following at the May 11 meeting:

1. Why can't we do better to: apply clinical guidelines to practice, control blood pressure, and prevent hypertension?
2. What are the best ways to identify new activities that could translate research results into practice? What are these better ways?
3. After three decades of activities, how can the CC avoid the natural tendency to rest on its laurels?
4. How should the CC come together to "seize the day" so there is collective and solid action?