UCSF-led hypertension strategy improves blood pressure control across UC Health

A new tool called the UC Way Hypertension Medication Algorithm has improved blood pressure control for at least 68% to approximately 74% of the 90,000 patients in the University of California Health system, according to a recent study published in BMJ Open Quality. It is one of the few programs of its kind developed for an entire health system to control hypertension.

“This improvement amounts to about 4,860 people who now have controlled blood pressure, which translates to 72 strokes, 48 heart attacks, and 38 deaths averted,” lead author Sandeep P. Kishore, M.D., Ph.D., an internist and associate professor of medicine at the University of California, San Francisco, who specializes in cardiometabolic health, said in a news release. “These are real Californians who didn’t end up in an emergency room, didn’t have a disability and didn’t lose time with their families.”This includes approximately 11,500 patients who were treated at UCSF alone.

The UC Way Hypertension Medication Algorithm was implemented in 2023 across six UC academic medical centers. It was developed by a team of UC Health experts, including cardiologists, pharmacists and data scientists. Affordability was a top priority for experts because it is one of the biggest barriers to medication intensification, which is one of the most important drivers of blood pressure control.

Barriers are especially large in vulnerable communities such as Black and Hispanic adults. For example, by age 55, 75% of Black adults develop hypertension compared with 54% of white men and 40% of white women, the study says.

The algorithm recommends medications and doses in five steps and is integrated into UC’s electronic health records. The algorithm recommends that every two weeks, patients are advanced to the next step or that their dosages are adjusted, when appropriate, based on clinician judgment and patient response.

Treatment is often more effective with a two-drug combination, and for this reason, an angiotensin receptor blocker/thiazide combination was chosen as the preferred initial therapy based on its affordability.

“The challenge isn’t the science — we know how to control blood pressure,” he added. “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."

The UC tool increased blood pressure control for Black patients, from 63.4% in 2023 to 67.3% in 2025.

Hypertension remains one of the leading drivers of preventable cardiovascular disease in the United States, affecting more than 119 million Americans. Often called a “silent killer,” it can go undetected for years while increasing the risk of stroke, heart attack and kidney disease.

Although it can be treated with medications, lifestyle changes can decrease symptoms, too. These include decreasing the amount of salt in your diet, stopping smoking and losing weight if necessary.

Kishore notes that other health systems could adapt the UC Health tool for their own needs, adding that similar efforts are already underway at UC to manage diabetes.