The Role of Olmesartan Medoxomil-Based Combination Therapy in the Management of Hypertension: A Review for Nurse Practitioners

Abstract

Background: Uncontrolled hypertension increases the likelihood of cardiovascular morbidity and mortality and places a great burden on health care systems. Hypertension (defined as a blood pressure [BP] of greater than (>) 140/90 mm Hg or >130/80 mm Hg in patients with diabetes) is amenable to treatment through lifestyle changes or pharmacological intervention. Although prevalence of hypertension has remained stable through recent years, advances in patient education and the availability of effective antihypertensive agents has allowed patients to better control their BP. Angiotensin II receptor blockers (ARBs) are a widely prescribed class of antihypertensive agents, and the ARB olmesartan medoxomil (OM) has been shown in clinical trials to effectively reduce BP with a placebo-like safety and tolerability profile.Purpose: To review the efficacy of OM-based treatment algorithms in patients with uncontrolled hypertension in specific demographic groups and to discuss the role of the nurse practitioner in the management of hypertension. Conclusions: Nurse practitioners hold a distinctive role at the forefront of primary care, which enables them to identify at-risk patients, ensure accurate diagnosis of hypertension through the proper measurement of BP, provide counseling on lifestyle changes, and prescribe effective pharmacotherapy. Safety and efficacy profiles of OM facilitate its inclusion into combination treatment algorithms when additional antihypertensive agents are needed to achieve desirable BP control. Clinical Implications: Clinical practice guidelines have established the paradigm that treating patients to defined BP goals may enable better patient outcomes. However, not all patients are managed to established goals. Issues of adherence, regimen complexity, and recognition of the need to escalate from monotherapy to combination therapy are common barriers to effective patient management.