Page 281 - Encyclopedia of Nursing Research

248 n HyperTeNSION

the patient as a central figure and may also Future work will need to improve
include the nurse, health educator, commu- translation and dissemination of effective
H nity health worker, nutritionist, pharmacist, strategies into practice. This need is height-
and physician. Optimal management of ened all the more by the increasing burden
HTN requires collaboration between patients of HTN now in developing countries and
and providers, collaboration among team the anticipated increase in HTN in devel-
members, and effective intervention within oped countries with the rising obesity epi-
the health care organization (coordinating demic (Dennison et al., 2007). Because of
committee of the National High Blood this growing epidemic of obesity and meta-
pressure education program, 1984; Miller, bolic syndrome, nurses, other clinicians, and
Hill, Kottke, & Ockene, 1997). researchers should also anticipate increas-
Nurses have a key role in all aspects ing rates of HTN at younger ages. Greater
of a collaborative approach to HTN man- focus on prevention, including attention to
agement, from screening to identify unde- social and behavioral determinants of HTN,
tected HTN, to conducting research, to will improve our ability to respond to the
setting national policy. The role of the indi- growing global burden of HTN. Finally, tai-
vidual nurse depends on his or her prepara- loring interventions according to culture,
tion, work experience, and practice setting. language, social environment, and behav-
physician–nurse teams have been an effec- ioral constructs has the potential to improve
tive method of delivering HTN treatment the effectiveness of interventions and may
plans in many settings (canzanello, Jensen, help address health disparities in HTN.
Schwartz, Worra, & Klein, 2005; Dennison, In conclusion, HTN is a common and
peer, Steyn, levitt, & Hill, 2007; Dennison, major risk factor for cardiovascular disease.
post, et al., 2007; litaker et al., 2003). Within The prevalence is increasingly globally and
these settings, nurses provide any number is anticipated to rise in developed countries
of interventions, many of which have been as rates of obesity and metabolic syndrome
investigated by nurse researchers. In partic- rise. effective treatment of HTN includes
ular, nurses have a long history of delivering lifestyle modification and pharmacological
proven health education and health counsel- treatment. Although evidence-based algo-
ing interventions (Hill, 1989; Jones, 2008) and rithms for HTN prevention, detection, and
providing interventions aimed at treatment treatment have been widely promulgated
adherence (Hill, Miller, & De Geest; Kirscht, and HTN control rates have improved, the
Kirscht, & rosenstock, 1981; logan, Milne, rates remain suboptimal in subpopulations,
Achber, campbell, & Haynes, 1979), which is including Blacks, Hispanics, and those of
a key predictor of HTN control (chobanian low socioeconomic position. Achieving
et al., 2003). More recently, nurse practitioners further improvements in HTN control will
are increasingly taking the lead on managing require activated patients, providers, and
HTN in primary care settings, and a growing health care organizations. Nurses play a
body of evidence indicates they are effective key collaborative role in both research and
in this role (Glynn et al., 2010; laurant et al., practice.
2005). Nurses will continue to play a key role
in future research, dissemination, and imple- Cheryl R. Dennison Himmelfarb
mentation of effective interventions for HTN Laura J. Samuel
prevention and treatment. Martha N. Hill