Helping patients manage hypertension
Shelly Baldwin MSN, RN, CWOCN

August 2011 
Volume 41  Number 8
Pages 60 - 63
  PDF Version Available!

A MAJOR CARDIOVASCULAR health problem, hypertension affects over 70 million people in the United States, or one in three adults. Of those with hypertension, over 20% don't know they have it and over 50% don't have it under control.1 Uncontrolled hypertension increases the risk of stroke, heart failure, myocardial infarction, and kidney disease.2 (See Populations at risk.) Fortunately, hypertension is treatable and often preventable.To combat high treatment costs and complications associated with hypertensive disease, healthcare professionals must adopt patient self-management programs that emphasize patient education and healthy behaviors. The U.S. Department of Health and Human Services recommends using a team approach that includes dietary, pharmacy, and social service, with all healthcare professionals sharing decision-making.3 This article describes how nurses can do their part to educate patients with hypertension to improve health outcomes.Begin by becoming familiar with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines and be on the lookout for the JNC 8 in spring of 2012, the expected release date.2 JNC 7 defines hypertension as a systolic BP of 140 mm Hg or more or a diastolic BP of 90 mm Hg or more. Patients with systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg are classified as prehypertensive. Normal BP is a systolic BP of less than 120 mm Hg and diastolic BP of less than 80 mm Hg.2 A patient's risk of cardiovascular disease (CVD) doubles with each BP increment of 20/10 mm Hg above 115/75 mm Hg.2The recommended treatment for patients with prehypertension or hypertension includes health-promoting lifestyle modifications to prevent CVD.2 These include weight control, nutritional management, and regular aerobic physical activity. Other behavioral modifications include smoking cessation and reducing alcohol intake. Some patients need medication when

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