Interdisciplinary approach to the management of hypertension: Does it work?

In large multisite hypertension clinical trials such as MRFIT, HDFP, and SHEP, educational and behavioral interventions delivered by interdisciplinary teams dramatically reduced cardiovascular morbidity and mortality through risk factor modification. Other trials, including TOHP I and TOMHS, used similar strategies to demonstrate significant differences in lifestyle modification and quality of life associated with effective risk reduction. Additional studies of various designs and size have documented the value of a team approach - with physicians, nurses, pharmacists, behavioral psychologists, dieticians, and lay workers - in managing hypertension. The critical question today, in the face of declining national rates of hypertension awareness, treatment and control is: Why are we not achieving better results in clinical practice given what has been documented in trials for more than 30 years?.