Hypertension Resources

For the purpose of this article, the long-term conditions covered in relation to hypertension are diabetes, asthma/chronic obstructive pulmonary disease (COPD), autoimmune rheumatic diseases and inflammatory bowel disease (Crohn’s/colitis), which for general practice nurses (GPNs) are often managed routinely in daily practice. This article not only explores why monitoring is required while reviewing the diagnosis of hypertension and long-term conditions, but also considers the impact on existing disease trajectories. In addition, both pharmacological and non- pharmacological measures are discussed for patient-centred care.

Around 12 million people in the UK have been diagnosed with hypertension (i.e. blood pressure [BP] greater than or
equal to 140/90mmHg) and over five million people have undiagnosed hypertension, which, if left untreated, can lead to premature ill health and death (Blood Pressure Association, 2008).

The risks associated with increasing BP are continuous — with each 2mmHg rise in systolic BP there is a 7% increased risk of mortality from ischaemic heart disease and a 10% increased risk of mortality from stroke (Lewington et al, 2002). However, although BP-lowering strategies have been shown to significantly reduce the risk, population-based studies consistently demonstrate that patients are unaware of the causes and effects of hypertension, and around two-thirds of those diagnosed remain untreated or inadequately controlled (Falaschetti et al, 2009; Antikainen, 2010). This article re-examines the evidence and guidelines to see how we can improve practice within this important area of  cardiovascular disease prevention.