Treating the hypertensive patient in a nurse-led hypertension clinic.
OBJECTIVE
This manuscript presents results from 4 years experience in a nurse-led hypertension clinic. The aim of the hypertension clinic was to optimize hypertension treatment and to reduce the number of physician consultations.


METHODS
All patients were initially examined by cardiologists. All follow-up visits were performed by nurses. They initiated and titrated antihypertensive medication according to a stepwise treatment algorithm or the physicians' instructions. The blood pressure (BP) measurement technique and the recording of risk profile were performed as instructed by guidelines from the European Hypertension Society.


RESULTS
During the first 4 years, 186 patients were treated in the hypertension clinic. One hundred and thirty patients were treated by the nurses alone and hereafter discharged to general practitioners; 95% of these patients reached target BP. Most of the patients received combination therapy with two to seven different antihypertensive drugs. The three primary antihypertensive drugs (calcium-channel blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and diuretics) were the first drugs to be used and they made up the main part of the combination therapy.


CONCLUSIONS
In spite of many risk factors, co-existing cardiovascular diseases and severe hypertension, 95% of the patients achieved target BP when treated in a nurse-led hypertension clinic. We suggest that the data serves as an inspiration for other clinics and GPs to implement the concept.
Andersen
Ulla Overgaard
UO
Division of Cardiology, Medical Department, Holbaek, Sygehus Nord, Region Sjaelland, Denmark. Ullaoa@dadlnet.dk
Simper
Anne Marie
AM
Ibsen
Hans
H
Svendsen
Tage Lysbo
TL
D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000451:nursing* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010351:Patient Discharge; D012017:Referral and Consultation; D012307:Risk Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics