Table 1.
Key lessons learnt in implementing hypertension control programs
| 1. Drug‐ and dose‐specific protocols: National and subnational consensus on specific protocols is possible and necessary for progress |
| 2. Fixed dose combinations: Fixed dose combinations are an evidence‐based, rational approach to hypertension control |
| 3. Drug supply: Supply of quality‐assured medication is irregular or absent in many areas, resulting from insufficient financing and suboptimal procurement models, despite availability of affordable best‐in‐class medications that minimize adverse events |
| 4. Blood pressure measurement: High‐quality, independently validated automated (digital) BP monitors are preferable but are often resisted by practitioners |
| 5. Team‐based care: Task sharing is essential, but nonphysician health workers often are not authorized to prescribe, titrate, or refill medications |
| 6. Patient‐centered services: The biggest barriers to adherence are system weakness and limitations, not patient behaviors; systems should minimize barriers to adherence, including elimination of co‐payments, provision of 3‐6 month prescriptions for patients who are stable, access to blood pressure monitoring, and convenient access to care |
| 7. Monitoring: Information systems are not easy to implement, particularly because of difficulties with patient identification, patient flow, paper‐based systems, and Internet bandwidth; the Simple app can support programs to improve patient care |
| 8. Private sector: It is necessary to improve hypertension standards and practice in the private medical sector |
| 9. Accountability: Improving hypertension treatment both requires and facilitates effective primary health care services; political will and civil society demand is critical to accelerate progress and scale up efforts |
| 10. Prioritization: The public health and clinical challenge of global hypertension control can be met, but will require giving priority to hypertension control and using simple, scalable interventions, implemented with collaboration and persistence |