Hypertension control

The proposal is a hypertension-control operating system for accountable primary-care networks. It does not invent a new drug. It makes the existing control loop dependable: accurate measurement, confirmed diagnosis, appropriate clinician-supervised treatment, continuous medicine availability, follow-up, and sustained control. The system has six parts. First, support population prevention through sodium reformulation, labeling, tobacco control, and healthier food environments. Second, create a quality-assured measurement network using validated automated devices, correct cuff sizes, standard technique, repeat readings, and clinical escalation. Third, encode a locally approved WHO HEARTS-style treatment protocol with simple drug-and-dose-specific paths and single-pill combinations where appropriate. Fourth, forecast medication demand and expose stockouts. Fifth, route follow-up until control is sustained. Sixth, maintain a population registry that makes failures visible. The north-star metric is sustained blood-pressure control among all eligible people in the service population. Supporting measures are diagnostic confirmation, treatment initiation, median time to control, retention at 6 and 12 months, stockout days, adverse events, equity gaps, and cost per controlled patient-year. App engagement is not success. The first buyer should be a government, insurer, employer, pharmacy network, or provider group that bears downstream cardiovascular costs. The preferred contract pays for verified controlled patient-years, with retention, safety, and equity safeguards. A premium direct-to-consumer longevity product aimed at low-risk users is the wrong wedge. Run a bounded 90-day implementation across 3 to 10 clinics with an accountable clinical lead and medicine partner. Establish the baseline, deploy devices and workflow, review safety weekly, then compare control, retention, stockouts, and cost with the prior workflow and a matched comparison where possible. Advance only if the system improves sustained control without increasing serious adverse events. WHO estimates that controlling hypertension in half of affected people could prevent 76 million deaths by 2050 and save about $100 billion in health costs each year. No company can claim that whole result. The proof is one care network that reaches durable majority control, then repeats it. The full proposal, medical boundary, evidence, and falsification criteria are maintained in research/hypertension/WHITEPAPER.md.