High blood pressure (hypertension) is a common condition throughout the world (prevalence from 20% to 50% in adults in developed countries, not just in the United States (Wierzejska et.al, 2019). The global indications cannot be understated. HT is indirectly the leading cause of death and the third cause of disability globally and its long-term effects include damage to such organs as blood vessels, heart, and kidneys (Wierzejska et.al, 2019). In America alone over 400,000 deaths occur per year that are a result of this cardiovascular disease (CDC, 2021). Approximately 75 million adults (1 in 3) suffer from high blood pressure, and it costs roughly $48.6 billion annually which is broken down into the health care services, medications, and loss of productivity from premature death (CDC, 2021). The numbers are staggering considering that it is treatable, if not preventable.

That is the purpose of my evidence-based project. Once it has been determined that a person has hypertension, what is the best and most cost-effective way to treat it? Is it bariatric surgery or is a pharmacological approach better for losing and maintaining an appropriate weight to lower the hypertension? There are studies in support of both methods. The data shows that success is dependent on the participant to keep the weight off. Surgery is considered a more permanent way to accomplish that and thereby providing an avenue to lower the cost overall. Medical therapy should allow the patient to stop taking medications, but it will require a life-style change. Participants may not take prescriptions anymore but are getting hit in the pocketbook with a more expensive, healthier-options, grocery list or a gym membership. Bariatric surgery is not without its own concerns. The costs vary by location, starting as low as $15,000 in some areas and going as high as $30,000 in other places. There are also different types of surgeries, so it is up to the patient and provider to determine which one is best.

There are not many financial considerations that need to be made as the program is already in place; however, I would like to implement some additional tools. All of the staff need to be knowledgeable about the surgery as it relates to hypertension and that may require some additional training. An update to the software would be needed because participants will be given monitors to use at home to check their pressure on a daily basis and enter it into the software. This will apply the doctor and counselors to have a better idea of what is going on along with the patient’s activities and eating choices. Lastly, providing snack options that patients can try to see if they would be able to incorporate it into their diet plans would be a good incentive. Since the program is a part of the hospital, the funds would be asked for from the board.

References:

CDC. (2020). Health topics – High blood pressure. https://www.cdc.gov/policy/polaris/healthtopics/highbloodpressure/index.html

Wierzejska, E., Giernas, B., Lipiak, A., Karasiewicz, M., Cofta, M., & Staszewski, R. (2019). A global perspective on the costs of hypertension: A systematic review. Archives of Medical Science, 16(5). doi: https://doi.org/10.5114/aoms.2020.92689