A blood pressure program adopted at six University of California academic medical centers effectively lowered high blood pressure and prevented serious illness and death in thousands of patients, according to a new study led by the University of California, San Francisco.
Hypertension affects nearly half of Americans and is a leading cause of death, especially among underserved populations. It can also cause heart disease, heart failure, stroke, kidney disease, and pregnancy complications.
This new tool is one of the few developed to control high blood pressure across the health care system, improving blood pressure control from 68.5% to nearly 74% in 90,000 patients, including 11,500 at UCSF. This research BMJ open qualitylasted two years and ended in mid-2025.
“With this improvement, approximately 4,860 people were able to control their blood pressure, which translated into 72 strokes, 48 heart attacks, and 38 deaths averted,” said lead author Sandeep P. Kishore, M.D., a physician and associate professor of internal medicine at UCSF who specializes in cardiometabolic health. “These are real Californians who didn’t end up in the emergency room, didn’t get disabled, and didn’t lose time with their families.”
Whole system approach
The new tool, called the UC Way Hypertension Treatment Algorithm, allows clinicians to tailor treatment to individual factors and special populations, such as the elderly, while increasing drug type and dosage according to a stepwise approach. It is integrated into UC’s electronic medical record.
The tool was developed by a multidisciplinary team of UC Health experts, including cardiologists, internists, primary care physicians, nurses, pharmacists, and data scientists. The group began meeting in 2020 to create a comprehensive strategy focused on reducing drug affordability and treatment variation across diverse patient populations. The UC Way tool was implemented system-wide in 2023.
In addition to medication, study experts recommend common-sense lifestyle habits to improve blood pressure, including quitting smoking or tobacco use, limiting alcohol intake (two drinks a day for men and one for women), limiting sodium (less than 1 teaspoon a day for most adults), at least 150 minutes of exercise per week, losing weight if you are overweight (BMI of 25 or higher), eating a healthy diet, and regularly using a home blood pressure monitor.
Almost 120 million adults in the United States have high blood pressure, which can damage arteries, and an additional 37 million have more severe conditions. Only about half of people with high blood pressure can control their blood pressure with medication or lifestyle changes.
The problem is especially acute among some populations, including black and Hispanic adults. For example, by age 55, 75% of black adults develop high blood pressure, compared with 54% of white men and 40% of white women. UC Health tools increased hypertension control rates among Black patients from 63.4% to 67.3%. However, disparities remain, the authors said, highlighting the need for more targeted interventions.
Beyond high blood pressure
UC is one of the nation’s largest public academic health systems, with more than 9 million outpatient visits annually. The UC Way program could be used by other health systems to standardize high blood pressure treatment or applied to treat other chronic diseases, Kishore said.
“Similar efforts are currently underway at the University of California, Heath for diabetes, and the approach may be adapted for other conditions in the future,” he said.
The challenge is not science. We know how to control blood pressure. This is all about setting a focus for the entire system that actually moves the needle. UC Health’s experience shows that with the right infrastructure and efforts, large, complex health systems can improve blood pressure control and prevent heart attacks and strokes. ”
Sandeep P. Kishore, MD, UCSF Internal Medicine Physician and Associate Professor
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University of California, San Francisco
Reference magazines:
Kishore, S.P.; others. (2026). A scalable treatment algorithm focused on hypertension management at the University of California. BMJ open quality. DOI: 10.1136/bmjoq-2025-003753. https://bmjopenquality.bmj.com/content/15/1/e003753
