What is a certified hypertension center?
A certified hypertension center is a medical facility specializing in the care of patients with high blood pressure that has been awarded the designation “DHL® Certified Hypertension Center” by the German Hypertension League (Deutsche Hochdruckliga e.V., DHL®) as part of a certification process. This designation is awarded exclusively to hospitals, medical practices, or care centers that have demonstrated specialized expertise in the diagnosis and treatment of high blood pressure and that also meet the high-quality standards and strict certification criteria defined by the German Hypertension League (Deutsche Hochdruckliga e.V.) DHL® – German Society for Hypertension and Prevention—based on scientific findings and studies in hypertension research.
With the “DHL® Certified Hypertension Center” certification, which has been awarded since September 2012, the German Hypertension League aims to make a significant contribution to improving and ensuring the quality of care for patients with high blood pressure. Clinics or medical practices wishing to become certified as hypertension centers must first complete an application and assessment form detailing the extent to which they meet the quality standards and certification criteria defined by the DHL. These criteria for certified hypertension centers include, among other things,
- requirements regarding specialized staff and facilities,
- diagnostic and therapeutic requirements, as well as
- regular continuing education and training.
In addition, certified hypertension centers must demonstrate collaboration with all medical disciplines involved in the care of patients with high blood pressure. The certificate is awarded only after a hypertension center has demonstrated, as part of a certification process lasting several weeks, that it meets all required quality standards and criteria.
Which medical specialties are involved in a hypertension center?
The diagnosis and treatment of high blood pressure generally require interdisciplinary collaboration among experts from various medical specialties. Interdisciplinary collaboration among all medical departments involved in the care of patients with high blood pressure is therefore one of the most important criteria for certification as a hypertension center. The medical specialties that must demonstrably collaborate with one another in certified hypertension centers, in accordance with the DHL’s catalog of requirements, include
- cardiology,
- endocrinology,
- nephrology,
- neurology,
- radiology,
- laboratory medicine,
- pediatrics, and
- gynecology.
Background Information on High Blood Pressure (Hypertension)
High blood pressure is a condition of the arterial vascular system in which blood pressure in the circulatory system is persistently elevated. Medical professionals also refer to this as hypertension or arterial hypertension. According to estimates, between 20 and 30 million people in Germany suffer from high blood pressure. Among people over the age of 65, about one in two is believed to be affected. High blood pressure is thus considered a widespread disease. However, only one in two people is aware of their condition. Of those affected who know they have high blood pressure, only about 40 percent are receiving treatment.
If high blood pressure remains untreated, it can damage vital organs such as the heart muscle, the coronary arteries, the brain, the kidneys, or the peripheral blood vessels over time. This can lead to life-threatening conditions such as a heart attack or a stroke. To prevent this, effective treatment of high blood pressure is of the utmost importance. Various treatment options are available, including, for example, medication such as diuretics, ACE inhibitors, or calcium channel blockers.
Patients with high blood pressure require specialized care that demands specific expertise and meets high medical quality standards. Since certified hypertension centers are best able to ensure such care, patients should ideally seek treatment at a medical facility that has a proven track record of extensive experience and specialized expertise in the field of hypertension treatment.
Goals of Certified Hypertension Centers
Through the certification of hypertension centers, the German Hypertension League (DHL) aims, first and foremost, to ensure and improve the quality of care for patients with high blood pressure. For this reason, the DHL has defined high-quality standards and eligibility criteria—based on findings from hypertension research and health services research—that medical facilities must meet to be successfully certified as hypertension centers. Consequently, only those clinics and practices that have demonstrated their suitability and high quality standards through a comprehensive review receive the designation “DHL® Certified Hypertension Center.”
Furthermore, by certifying hypertension centers, the German Hypertension League aims to make the quality of hypertension treatment transparent for patients and to support those affected in finding a suitable medical facility for their treatment. Since there is a wide range of options available for the diagnosis and treatment of high blood pressure, and since their quality and effectiveness cannot be properly assessed by medical laypersons, patients are often overwhelmed when choosing a suitable facility. However, if a clinic or practice holds certification as a Hypertension Center, patients can be confident that they will receive treatment there at a high medical standard and based on the latest scientific findings.
Hospitals and medical practices should also be able to benefit from the designation as a certified hypertension center. This designation demonstrates that they have been evaluated against external quality standards and have met those standards. This is intended to strengthen patients’ trust in certified hypertension centers and help these centers attract new patients.
Certification of Hypertension Centers
Hospitals and medical practices that wish to be certified as hypertension centers must undergo a certification process lasting several weeks. The first step in this process is completing the application and assessment form. In this form, the hypertension centers seeking certification must demonstrate the extent to which they meet the requirements and quality standards set by the DHL. In addition, they must provide the necessary documentation and undergo an on-site inspection. Only after successfully completing this certification process for hypertension centers will the clinic or practice finally be awarded the designation “DHL® Certified Hypertension Center.” This designation is valid for three years. At the end of these three years, a certified hypertension center must undergo a recertification process.
Criteria for Certification as a Hypertension Center
The German Hypertension League (Deutsche Hochdruckliga e.V. DHL®) – German Society for Hypertension and Prevention has defined a set of quality requirements and criteria that certified hypertension centers must meet. These requirements are based on scientific findings and studies in hypertension research and pertain, among other things, to interdisciplinary collaboration among all participating medical departments, the availability of specialized staff, facilities, and equipment, the range of therapeutic and diagnostic services, and regular continuing education in the field of hypertension treatment:
- Staffing Requirements: Certified hypertension centers must employ at least two DHL®-certified hypertension specialists. In addition, a DHL®-certified hypertension assistant is desirable.
- Interdisciplinary Collaboration: Certified hypertension centers must ensure collaboration with the medical specialties of endocrinology, cardiology, nephrology, neurology, radiology, laboratory medicine, pediatrics, and gynecology. These medical disciplines do not need to be located in the same hospital or clinic building, but must be available and accessible for the examination and treatment of the facility’s patients with high blood pressure.
- Facility Requirements: Certified hypertension centers must have facilities for the outpatient and inpatient diagnosis and treatment of hypertension, as well as a hypertension outpatient clinic.
- Diagnostic Procedures: Certified hypertension centers must, as a general rule, be able to perform the following diagnostic procedures—either in-house or through collaborations with other facilities:
- Basic diagnostics, including ECG, long-term blood pressure monitoring, and long-term ECG
- General X-ray diagnostics
- Ultrasound procedures: Renal sonography with color-coded duplex sonography (CCDS) of the renal vessels, CCDS of the abdominal vessels, the cerebral vessels, and the peripheral arteries
- Echocardiography
- Computed tomography (CT), magnetic resonance imaging (MRI), angiography
- Nuclear medicine diagnostics
- Laboratory medicine: guideline-based laboratory diagnostics, including specialized endocrinological diagnostics and laboratory diagnostics for kidney diseases
- Screening for sleep-related breathing disorders
- Cardiac Catheterization Lab
- Interventional angiology
- Therapeutic Requirements: Hospitals must meet the following therapeutic requirements to be certified as a hypertension center (private practices must demonstrate a partnership with an appropriate clinical facility):
- Guarantee of emergency therapeutic care through an internal medicine intensive care unit, a 24-hour emergency department, and a 24-hour acute neurology unit
- Availability of a facility for non-pharmacological interventions (dietary counseling, sports medicine)
- Regular continuing education and training: Certified hypertension centers must offer regular continuing education and training for physicians and patients
