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Table 3
Strategies to promote HTN control
H
Actions
Actions by Patients
engage in essential prevention and treatment behaviors
Decide to control risk factors
Negotiate goals with provider
Develop skills for adopting and maintaining recommended behaviors
Monitor progress toward goals with home blood pressure monitoring
resolve problems that block achievement of goals
patients must communicate with providers about prevention and treatment services
Actions by Providers
providers must foster effective communication with patients
• Provide clear, direct messages about importance of a behavior or therapy
• Include patients in decisions about prevention and treatment goals and related strategies
• Incorporate behavioral strategies into counselling
providers must document and respond to patient’s progress toward goals
• Create an evidence-based practice
• Assess patient’s compliance at each visit
• Develop a reminder system to ensure identification and follow-up of patient status
provide evidence-based treatment to goal, using JNc 7 guidelines
Actions by Health Care Organizations
Develop an environment that supports prevention and treatment interventions
provide tracking and reporting systems
provide education and training for providers
provide adequate reimbursement for allocation of time for all health care professionals
Adopt systems to incorporate innovations rapidly and efficiently into medical practice
Adopt policies and practices that address disparities in HTN
Adapted with permission from Dennison, c. r., Houston Miller, N., & cunningham, S. (2010).
Hypertension. In S.Woods, e. Froelicher, S. U. Motzer, & e. Bridges (eds.), Cardiac nursing, (6th
ed.). philadelphia, pA: Wolters Kluwer Health/lippincott Williams & Wilkins. Originally
taken from Miller, N. H., Hill, M. N. Kotke, T., et al (1997). The multilevel compliance challenge:
recommendations for a call to action. Circulation, 95, 1085–1090.

7 treatment algorithm for HTN highlights lifestyle and pharmacological manage-
the importance of lifestyle modification in ment strategies require actions by patients,
addressing HTN, followed by pharmacolog- health care providers, and health care orga-
ical treatment to goal based on established nizations within a multilevel framework of
guidelines (chobanian et al., 2003). lifestyle action, as outlined in Table 3. A team-based
modification that has been shown to lower approach to HTN management has been an
Bp includes weight loss, increased physical effective strategy in many settings and may
activity, and dietary modification such as improve both consistent delivery of preven-
sodium and alcohol reduction and adoption tive services and adherence to treatment
of the DASH diet (a diet low in fat and rich in algorithms (carter, rogers, Daly, Zheng, &
fruits, vegetables, and whole grains with low- James, 2009; Norby, Stroebel, & canzanello,
fat dairy products; chobanian et al., 2003). 2003; Walsh et al., 2006). Teams should include