Standardized Treatment Algorithm Improves Blood Pressure Control

Hypertension is common and drives preventable cardiovascular, renal, and pregnancy complications. Control remains inconsistent across large care networks and disproportionately harms underserved communities. To address this, clinicians across the University of California implemented a standardized treatment approach, and a new study shows it improved blood pressure control at six academic medical centers.

The UC Way Hypertension Medication Algorithm, developed within UC Health and led by UC San Francisco, standardizes medication escalation and is embedded in the electronic health records. Clinicians can still individualize therapy based on patient characteristics and special populations, including older adults.

Multidisciplinary teams began designing the program in 2020 and deployed it systemwide in 2023 to reduce treatment variation and improve affordability. In a two-year evaluation ending mid-2025, blood pressure control rose from 68.5% to nearly 74% across 90,000 patients. Findings were published in BMJ Open Quality on March 18, 2026.

Control among Black patients increased from 63.4% to 67.3%, although disparities persisted, highlighting the need for more targeted interventions. The authors recommend pairing medication management with lifestyle changes and home monitoring. UC Health is now adapting the approach for diabetes and may extend it to other chronic diseases.

"The challenge isn't the science—we know how to control blood pressure," said lead author Sandeep P. Kishore, MD, PhD, an internist and associate professor of medicine at UC San Francisco who specializes in cardiometabolic health. "This is all about having a system-wide focus that actually moves the needle. UC Health's experience shows that with the right infrastructure and commitment, large, complex health systems can improve blood pressure control and prevent heart attacks and strokes."