ABSTRACT
The Canadian Hypertension Education Program (CHEP), Canadian Hypertension Society, Blood Pressure Canada, Canadian Diabetes Association, College of Family Physicians of Canada, Canadian Pharmacists Association, Heart and Stroke Foundation of Canada, and the Canadian Council of Cardiovascular Nurses issued a recent call for all health care professionals in Canada to double their efforts to assist patients with diabetes in maintaining target blood pressures (Campbell et al., 2009b). Blood pressure (B/P) in diabetic individuals should be less than 130 mmHg systolic and less than 80 mmHg diastolic (CHEP 2009). Considering recognition and treatment of hypertension in people with diabetes can result in reductions in disability and death, control of hypertension must become an interdisciplinary priority. Maintaining B/P less than 130/80 mmHg requires lifestyle modification as the cornerstone to treatment and often two or more B/P medications (Campbell et al., 2009a). The cost of multiple drugs required for B/P control in diabetic individuals is one of the few treatments estimated to reduce overall health costs and related cardiovascular disease complications (Gillies, Abrams, & Lambert, 2007). Nurses are essential partners in assessing and assisting diabetic patients and all patients with hypertension to reduce overall cardiovascular risks. Nurses may also be key practitioners in assessing and monitoring patient difficulties with adherence to lifestyle or pharmacological interventions (Jayasinghe, 2009; McLean et al., 2008). Individualized lifestyle counselling and treatment modification are recommended to maintain target B/P and treat dysglycemia, dyslipidemia, smoking or any other cardiovascular risks in diabetic individuals.
Subject(s)
Diabetes Complications/complications , Hypertension/diagnosis , Hypertension/prevention & control , Mass Screening/methods , Nurse's Role , Nursing Assessment/methods , Canada/epidemiology , Early Diagnosis , Global Health , Health Planning Guidelines , Humans , Hypertension/complications , Hypertension/epidemiology , Life Style , Patient Education as Topic , Practice Guidelines as Topic , Risk Assessment , Risk Factors , Risk Reduction BehaviorSubject(s)
Delivery of Health Care/organization & administration , Education, Medical, Continuing/standards , Family Practice/methods , Hypertension/therapy , Physicians, Family/education , Canada/epidemiology , Clinical Competence , Humans , Hypertension/epidemiology , Interprofessional Relations , PrevalenceABSTRACT
Recent data from the World Health Organization (WHO) indicate that nearly one billion people in the world are suffering from hypertension. Forecasts suggest that, with the aging of the population, this number could reach 1.5 billion by 2025 (Kearney, Whelton, & Reynolds, 2005). In developed countries, more than one in five adults have hypertension (Vasan, Beiser, Seshadri, Larson, Kannel, & D'Agostino, 2002). Statistics for Canada reveal that fewer than 15% of those diagnosed with hypertension are adequately controlled (Joffres, Hamet, MacLean, L'italien, & Fodor, 2001). Part of the effort to improve hypertension detection, assessment and treatment is an annual process to produce and update evidence-based recommendations for the management of hypertension and to implement the recommendations (Zarnke, Campbell, McAlister, & Levine, 2000; Campbell, Nagpal, & Drouin, 2001). The most up-to-date 2007 Canadian recommendations for the assessment and management of hypertension are presented. Contemporary nursing practice requires that nurses take responsibility and a role in the primary prevention, detection and treatment of hypertension.
Subject(s)
Health Promotion/methods , Hypertension/prevention & control , Adult , Antihypertensive Agents/therapeutic use , Canada , Comorbidity , Evidence-Based Medicine , Humans , Hypertension/epidemiology , Hypertension/nursing , Life Style , Patient ComplianceABSTRACT
Congestive heart failure (CHF) is increasing in incidence and prevalence in both men and women in Canada. Research findings to date have been inconsistent with respect to whether gender differences influence quality of life, treatment and survival. There is a paucity of qualitative research describing the experience of patients with CHF This qualitative case study approach used semistructured interviews with women and men with New York Heart Association (NYHA) class three or four CHF who were referred to a CHF clinic. In addition to quality of life measures, data related to medical history, medical management and NYHA scores were collected to offer a thorough description of these clients' experiences. Three hypotheses were generated from 13 themes that emerged. First, the psychosocial impact of CHF outweighs the physical impact. Second, sex differences exist in relation to living with CHF with men being more accepting of CHF and more likely to experience social isolation and loss than women, while women are more likely to describe fear. Third, the experience of CHF is influenced by age with physical experiences and depression mentioned more frequently in younger age groups. Findings from this study have generated nursing implications and recommendations for further research.
