Awareness, Measurement, Treatment and Control of Hypertension

Hypertension is a complex, chronic condition that is often referred to as the "silent killer". Most cases of hypertension either are not diagnosed or go untreated. The condition is a key contributor to the development of cardiovascular and cerebrovascular disease, with nearly two-thirds of all cases of stroke and one-half of all cases of ischemic heart disease being directly attributable to hypertension.1.;The purpose of this paper-based thesis was to explore and design a community-based approach to improve blood pressure control. Given the great burden of illness of cardiovascular disease in patients with high blood pressure, investment in novel community-based strategies to improve the management of hypertension were and are still greatly needed. As such, a multicentre randomized trial utilizing advanced nurse practitioners and community pharmacists identified patients with diabetes and elevated blood pressure using recommended screening methods, and acted as a liaison between the patient and their primary care physician, and assisted in follow-up of these patients to achieve the recommended target blood pressure.;This final dissertation consists of 5 papers related to blood pressure measurement and hypertension management, whereby, four papers have already been published. The final fifth paper (unpublished) uses historical method to review selected nursing literature on blood pressure measurement between 1945 and 2000. The purpose of this historical research project was to undertake a beginning study of the history of blood pressure measurement in nursing.;Treatment and control of blood pressure is a major public health problem. Given the magnitude of this problem it is clear that traditional methods of patient screening and management, primarily through family physicians have been inadequate -- we need innovative community-based solutions whereby nurses and nurses practitioners playa role. Improvements to the delivery of primary care must go beyond the confines of the family physician's office and consider the important role that other community-based healthcare professionals can play.;1Lawes, C., Vander Hoorn, S. & Law, H. Blood pressure and the global burden of disease 2000. Part II: Estimates of attributable burden. Journal of Hypertension, 24, 423-430.