The 5 A’s of Primary Care Management for Hypertension Prevention

For High Blood Pressure Awareness Month, Ambassador Dr. Mushmoom Khan, a Family Medicine resident physician in New York working in both inpatient and outpatient medicine, shares tips on preventing hypertension, which is a leading cause of cardiovascular disease worldwide. 

When focusing on primary prevention of hypertension, an easy way to remember is to use the 5 A’s:



Risk Factors, Behaviors, Symptoms, Attitudes, Preferences

For every patient that comes to your office, assess and address lack of physical activity, an unhealthy diet, obesity, cigarette smoking, and risky/harmful alcohol, family history and race/ethnicity. Explore social determinants of health. Although hypertension is due to a combination of environmental and genetic risk factors, social determinants of health are also risk factors for hypertension.  Social determinants of health are broadly defined as “the circumstances in which people are born, grow, live, work, and age, and the systems put in place to deal with illness”.  Socioeconomic status such as wealth and income, education, employment/occupation status, and access to transportation and health care play a huge role in preventing and treating high blood pressure.  Lastly, gain perspective into any cultural beliefs that may affect them.



Personalized Options that can Decrease Risk and Improve Quality of Life

Educate them on the complications high blood pressure can have on their body.



Collaboratively Select Goals Based on Patient Interest and Motivation

Ask your patients what they know about hypertension and why it could be harmful.  Then come up with a plan together.



Provide Information, Teach Skills, Problem Solve

Use your expert knowledge and resources in whatever way you can once you've reached your assessment.



Specify Plans for Follow-Up

Schedule a follow up visit or call to closely make sure they are compliant with the education provided or medications, and adjust accordingly.


I hope you find my tips useful and can prevent hypertension in your patients too! We can have a bigger impact on our patients and their quality of life, so let's work together for a healthier tomorrow. 


For more information, be sure to follow Dr. Khan @primarycaredoc.


Source:  Diagram adapted from: Glasgow, R. E & Nutting, P. A. (2004). Diabetes. In Handbook of Primary Care Psychology. Ed., Hass, L. J. (pp. 299-311)

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