Nurse-led management of hypertension

[摘要] In their comprehensive review of recent advances in cardiology in primary care, Fahey and Schroeder1 looked at new models of care including nurse-led management of hypertension. We analysed trials from UK general practices of change in systolic blood pressure after a nurse-led intervention until 2002. These showed a combined reduction in systolic blood pressure of only 3mm Hg — a fall that could just be due to accommodation.2 By contrast the landmark American Hypertension Detection and Follow-up trial showed that an organised system of regular follow up and review of hypertensive patients using a stepped care approach to treatment reduced not only blood pressure but also mortality over 5 years.3 The vital difference between this and the British community-based trials is that it included change in drug treatment to achieve target blood pressure.

[学科分类] 卫生学