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Over the past 3 decades, a substantial body of high-quality evidence has guided the diagnosis and management of elevated bloodpressure (BP) in the outpatient setting. In contrast, there is a lack of comparable evidence for guiding the management of elevated BP in the acute care setting, resulting in significant practice variation.
UVA Health's Karen Johnston, MD, the SHINE trial leader, was pleased to see the new insights into bestpractices for stroke care. The SHINE trial suggests that we as providers need to have a similar concern for high blood sugar after stroke treatment as we do already with other risk factors, such as high bloodpressure.”
Based on current evidence, we advocate for the widespread adoption of an early bundle of care for patients with intracerebral hemorrhage focused on time-based metrics for bloodpressure control and emergency reversal of anticoagulation, with the goal of optimizing the benefit of these already widely used interventions.
Bloodpressure guidelines serve as a beacon of bestpractice for the diagnosis and management of hypertension. Similar to preceding hypertension guidelines, the 2018 guideline highlighted the myriad risks associated with inadequate bloodpressure management and the importance of improving bloodpressure control.
Earlier identification, along with order set initiation, supports best practice.Method:Patients presenting with nontraumatic HA are assessed by an ED RN to determine if HA reached maximum intensity within one hour of initial onset. If criterion is met, a bestpractice alert (BPA) triggers within the electronic medical record.
Project analysis began by identifying care opportunities. Development of such a process raised the standard of care for this patient population and leads to overall improvement in patient management.
We could not show it in a short study like this, but I believe this approach of integrating genetic information into routine bestpractices could save lives and be a game-changer for patients and GPs. QRISK incorporates factors such as bloodpressure, cholesterol, BMI, smoking status, age, sex, and family history to estimate risk.
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