Care Of Hypertensive Patients Research Articles

The 1980 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure

The National High Blood Pressure Education Program has released three Joint National Committee reports and a task force report on the detection, evaluation, and treatment of high blood pressure. Like its predecessors, the 1988 Joint National Committee report was developed using the consensus process; it is based on the latest scientific research and reflects the state of the art regarding hypertension management. This report updates findings of previous reports in several respects: it broadens the step-care approach to provide more flexibility for clinicians; encourages greater patient involvement in the treatment program; emphasizes a consideration of the quality of life in the management of patients; and addresses the cost of care. It also provides more emphasis on control of other risk factors for cardiovascular disease; includes a discussion of the new cholesterol guidelines; recommends a reduction in alcohol consumption; and discusses the use of calcium and fish oil supplementation. This document expands earlier reports on special populations, including blacks and other racial and ethnic minority groups, young and elderly patients, pregnant patients, surgical candidates, and hypertensive patients with cerebrovascular disease, coronary artery disease, left ventricular hypertrophy, congestive heart failure, peripheral vascular disease, renal disease, chronic obstructive pulmonary disease or bronchial asthma, gout, diabetes mellitus, and hyperlipidemia. The report also updates previous drug tables to include new drugs, revised recommended doses of some drugs, and drug interactions. Consideration of step-down therapy after blood pressure has been controlled is suggested. This report is intended as a guide for practicing physicians and other health professionals in their care of hypertensive patients and as a reference for those participating in the many community high blood pressure control programs throughout the country.

Mastery learning model for an inservice nurse training program for the care of hypertensive patients.

Mastery learning as an educational model is defined and explained. This model was applied to the development of an inservice training program for registered nurses to enable them to manage stable hypertensive patients. The developmental process is described.

Evaluation of the Initial Care of Hypertensive Patients

Patterns of patient care were evaluated retrospectively from the records of 994 patients hospitalized at a university hospital, a community hospital, and two Veterans Administration hospitals. Arterial pressure was not obtained by the admitting physician in 26% of the patients; and in those in whom a blood pressure was recorded, it was elevated in 18%. Of 200 patients discharged with the primary diagnosis of hypertension, the history, physical examination, and diagnostic evaluation were clearly inadequate. Thus, unless physician-recognition and adequate evaluation are improved (through education) the practice of massive public health screening programs seems pointless.