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Hypertension - a contemporary approach to nursing care.

The incidence of hypertension is increasing as the number of patients with obesity and diabetes mellitus increases. Hypertension results when the peripheral vascular resistance is increased, the blood viscosity is elevated and/or the flow of blood through the main arteries is impeded. Chronic hypertension results in an enlarged heart, myocardial damage and lung and renal abnormalities. While some causative factors, such as obesity, can be controlled, others, for example genetics, are more difficult to treat because often there is more than one factor involved. This article explores how essential and secondary factors contribute to the incidence of hypertension and the physiological changes resulting from raised blood pressure. It proposes that although traditional treatment has some success, nurse-led clinics are having better success not only in controlling raised blood pressure but also in reducing cardiac, pulmonary and renal morbidity. Nurse-led clinics are more cost-effective, staff are more productive and clients are more compliant with treatment.