Implications for Acute Care APNs
As the number of persons at risk for the development of hypertensive crisis increases, acute care APNs need to be aware of the increasing public health burden of HTN and its associated comorbidities. Greater emphasis on treatment of those at risk for uncontrolled HTN and more aggressive treatment of persons with pre-HTN in the long run could decrease the number of patients who experience a hypertensive crisis. Patient education on the relationship between increasing body weight and HTN, diabetes mellitus, and cardiovascular disease must begin. All APNs share a responsibility to assist patients in obtaining information on diet and weight reduction and physical activity so that patients may more actively participate in management of their HTN. Furthermore, data from the JNC-7 and the Prospective Studies Collaboration indicate that reducing SBP by 10 mmHg or DBP by 5 mmHg reduces the risk of stroke-related death by 40% and coronary heart disease mortality by 30%.[3,33] Thus, the importance of medication adherence in preventing stroke and cardiovascular complications must be emphasized when counseling hypertensive patients.
In compliance with national ethical guidelines, the author, reviewers, and editors report no relationships with business or industry that would pose a conflict of interest. The authors do not present any off-label or non-FDA-approved recommendations for treatment. There is no implied endorsement by NPA, MNA, or ANCC of any commercial products mentioned in the article.
Journal for Nurse Practitioners. 2010;6(5):338-346. © 2010 Elsevier Science, Inc.
Cite this: Hypertensive Crisis in an Era of Escalating Health Care Changes - Medscape - May 01, 2010.