High blood pressure, also known as hypertension, affects millions of people in the U.S. It’s one of the leading causes of heart disease, stroke, and kidney problems.
Even with medication and lifestyle changes, many patients still struggle to bring their blood pressure down.
This long-term high blood pressure, known as persistent hypertension, can be hard to manage and increases the risk of serious health problems.
A new study from the Yale School of Medicine is helping doctors understand why blood pressure stays high for some patients—and how care can be improved.
The study looks at the many different reasons why people don’t respond to treatment and uses personalized tools and artificial intelligence (AI) to help fix the problem.
Why some people struggle with persistent hypertension
The study identified several key reasons why people might have uncontrolled blood pressure, even when they’re being treated:
Treatment-resistant hypertension: This happens when a person’s blood pressure stays high even though they’re taking the right medications. It may be caused by other health problems like kidney disease or hormone imbalances.
Undiagnosed hypertension: Some people don’t know they have high blood pressure because they don’t feel symptoms, so they don’t get treatment.
Inadequate treatment: A patient may not be on the right dose, or their medicine might not be the best choice for their condition.
Medication issues: Some people forget to take their pills, don’t understand how to take them, or stop because of side effects.
Barriers to healthcare: These can include missed appointments, cost of medicine, lack of transportation, or limited access to doctors.
To deal with this, researchers at Yale developed a system they call a “taxonomy”—basically, a way of grouping patients based on the specific challenges they face in managing their blood pressure.
Once doctors know what’s getting in the way, they can match the right solutions to the right people. For example:
If a patient can’t afford medication, a social worker could help them find financial support.
If the issue is forgetfulness, they might get reminder tools or help understanding how the medicine works.
If the patient’s body doesn’t respond to treatment, doctors may try different combinations of medications or additional tests.
To make this process faster and more effective, the team is using AI tools, including machine learning and natural language processing, to analyze information from electronic health records. This lets doctors quickly find patients with specific needs and offer help that’s tailored to them.
The researchers plan to test this approach at Yale New Haven Health System, starting with about 40,000 employees and their families. If it works, the system could be rolled out more widely—and even be adapted for other long-term health conditions like diabetes.
What you can do to manage high blood pressure
If you have high blood pressure, there are steps you can take to improve your health:
Eat a healthy diet rich in fruits, vegetables, whole grains, and low-fat dairy. Avoid too much salt, sugar, and processed foods.
Exercise regularly—even a brisk walk for 30 minutes most days of the week helps.
Maintain a healthy weight, as losing extra pounds can reduce blood pressure.
Limit alcohol (no more than one drink a day for women, two for men).
Quit smoking, since it damages blood vessels and raises blood pressure.
Take your medications exactly as prescribed. If you’re experiencing side effects or have trouble remembering to take them, talk to your doctor.
This study, led by Yuan Lu and her team, and published in Circulation: Cardiovascular Quality and Outcomes, shows that persistent high blood pressure isn’t always due to lack of effort or poor choices. Often, the issue is more complicated and requires a personalized approach.
By combining technology, human support, and targeted treatments, this new system offers a more thoughtful and effective way to care for people with high blood pressure. If successful, it could change how we treat not only hypertension, but many other chronic health conditions in the future.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more health information, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.
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