Hypertension: Evidence Based Practice

Since the introduction of automatic blood pressure equipment, manual blood pressure monitoring is becoming less common. Automatic blood pressure monitors are becoming predominant in clinical settings. This move towards technology is decreasing the exposure to manual blood pressure measurements (Cork, 2007). Manual blood pressures are an essential nursing skill that can affect a patient’s health and care. Providing the best patient care is the optimal outcome for all healthcare providers.

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

Cooper L.A., & Roter D.L., & Carson K.A., & Bone L.R., & Larson S.M., & Miller E.R. III, & Levine D.M. (2011). A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. Journal of General Internal Medicine, 26, 1297 â[euro]" 1304. 10.1007/s11606-011-1794-6

* The U.S. High Blood Pressure Education Program is a public-private cooperative effort formed to help reduce death and disability related to hypertension, which is at the root of 50% of those suffering heart attacks and two-thirds of those suffering strokes. Using a campaign that integrates social marketing to first build awareness of the “silent killer,” and then encourage action, awareness of the problem more than tripled to over 90% and those seeking treatment more than doubled within a single decade.

Two other complementary and alternative therapies consist of implementing meditation and relaxation to help lower blood pressure. Stress reduction plays a vital part in reducing blood pressure (Moffatt et al., 2010; Pirotte et al., 2012; Schmid et al., 2009). The results shown in a study conducted by Schmid et al. (2009) discussed beneficial nursing interventions including encouraging patient participation in support

The convenience sampling that was used in recruiting all male patients who were on blood pressure medications is a glaring bias in this study. There was no information provided addressing why the patients were presenting to the clinic. There are many interventions that can raise blood pressure. For example, the study conducted by Marshall, Anantharachagan, Choudhary, Chue and Kaurhis, (2002) investigated the effect of situational anxiety on blood pressure experienced in anticipation of a blood test. Marshall, et. al., (2002) found that anticipation of a blood test can raise blood pressure. Foster-Fitzpatrick, et. al., 1999 did not address the purpose of the patient’s visit to the clinic.

Bosworth, Olsen, Grubber, Powers, and Oddone (2012) conducted a three-arm randomized controlled trial to determine the differences in AAs and Caucasians in two self-management hypertension interventions (N=636; non-whites n=328, and whites n=308). The subjects were randomly placed in the usual care (UC), home BP monitoring (HBPM), a tailored behavioral self-management intervention (TBSMI), and the two groups combined (TBSMI + HBPM). Data collection was done at the initiation of the research, 12 months, and 24 months from the control and intervention groups. BP results on whites at the baseline and intervention groups did not differ, but there was significantly reduction in the systolic BP of 7.5 mm Hg in AAs. This study denotes that a home BP monitoring in combination of nurse-administered telephone behavioral intervention was most effective in BP control in AAs.

Nonetheless, this class encourages participation throughout the entire class. Class activities include health education, discussions about cardiovascular health, time for questions and answers, and blood pressure screenings. Information covered in the class include how to maintain a healthy blood pressure, lifestyle behaviors to adopt and dismiss, and hypertension management. Both the activities and information are crucial for older adults to fully understand the importance of cardiovascular health.

Objective: The aim of the integrative review was to assemble the best available evidence for effective nurse-led care interventions for high blood pressure control (HBP), and to identify evidence based strategies and their adaptability in a low resource primary setting in Uganda. Material and Methods: Literature search was conducted using the Medical subject terms hypertension/nurse*, Sub-Saharan Africa, Nurse-led/ Nurse run clinics in Medline via Pub Med and the Cochrane Central register of Controlled trials. Search limits were set to include articles published in English, past five years, involving only human subjects and adults. Only articles that included an intervention involving a nurse /pharmacist or physician in either a primary, secondary

Studies evaluating hypertensive patients’ perceptions of causes prompting their self-management have demonstrated that obstacles are multifactorial. Studies have shown that family members often play a vital role in patients’ hypertension self-management, including providing support with food choice and preparation, helping patients to follow the behavioral recommendations (for example, smoking cessation), and supporting patients with medication and medical appointment adherence. Family members may also play a central role in easing patient–provider thoughts about hypertension care (Wassertheil et al,

According to the above selection, the patient needs to be compliant, satisfied, and knowledgeable. Jozien Bensing, the author of this article, believes that “a nontraditional dimension which involves concern for psychosocial aspects of care” and patient satisfaction are most important for effective communication. Bensing believes that the attitude of the physician when he/she is speaking with the patient is also important. She suggests that with good attitude and affective behavior towards the patient makes for a better understanding. This article talks about studies that were performed on patients with hypertension and how all of the aspects Bensing claimed were important were in each study. There were general practitioners that consulted

With the information found with what a patient’s blood pressure is, it helps health care

Approximately one in every three adult’s ages 20 years old and older are diagnosed with high blood pressure or hypertension. Hypertension affects 78 million people in the United States and is equally prevalent in both men and woman (Crabtree et al., 2013). Hypertension is a major risk factor for cardiovascular disease (Hajjar & Kotchen, 2003). It can lead to stroke, myocardial infarction, renal failure, heart failure, neurological issues, and death if not detected early and not treated properly (James, Oparil, Carter, & et al., 2014). Approximately 9.4 million deaths in 2010 were attributed to high blood pressure (Angell, De Cock, & Frieden, 2015). About 54% of strokes, 47% of coronary heart disease, and 25 % of other cardiovascular diseases are attributed to high blood pressure (Arima, Barzi, & Chalmers, 2011).

Hypertension is the second leading cause of kidney failure in the United States (Centers for disease control, 2017). High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it. High blood pressure damages blood vessels in the kidneys, reducing their ability to work properly (National institute of diabetes and digestive and kidney diseases, 2016). About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure. Only 54% of these people have their high blood pressure under control (Centers for disease control, 2017). Hypertension education, which focuses on controlling the disease with diet and medication, is important in preventing or delaying the progression to kidney disease. Most people diagnosed with hypertensive disease will need to see a medical professional who will recommend dietary restrictions, treat high blood pressure, manage diabetes and hyperlipidemia, encourage smoking cessation, and remove any nephrotoxic medications to preserve kidney function and prevent kidney disease (Ignatavicius & Workman, 2006, p. 1742).

Another intervention is patient education such as teaching what is considered hypertension, how to check the