Group exercise improves patient compliance in mild to moderate hypertension.

One of the major problems of both pharmacological and non-pharmacological treatment is compliance of the patient. We attempted to reduce compliance problems by using group exercise in hypertensive patients. A group of 29 hypertensive patients (aged 54 +/- 10 years) met weekly for nearly 2 years. Each session (90-120 min) comprised four parts: endurance training, gymnastics and relaxation, education and a discussion of related problems such as nutrition and lifestyle. There was a significant decrease in systolic (9%) and diastolic (6%) blood pressures at rest and during exercise (systolic 12%), and an increased maximal work load (18%). In addition, drug treatment was substantially reduced (reduced in 56% of patients abandoned in 10% of patients). Cholesterol levels were reduced by 18%, although, during a 6-10 day nutritional report, fat made up 40% of the total calorific intake, indicating the need for individualized dietary advice. The major goal was to improve compliance and increase non-pharmacological treatment, exercise being a minor consideration which may have relevance for the treatment of hypertension.

Educating nurses in blood pressure measurement and hypertension control.

Today, self-measurement of blood pressure is seen as the optimal goal in improving the compliance of the hypertensive patient, but it can only be reached by using well trained medical staff. In this, the role of nurses is particularly vital. We administered a questionnaire to 77 nurses and 146 doctors to determine their levels of knowledge concerning blood pressure measurement techniques and pitfalls, and definition of hypertension. The general knowledge of both groups was insufficient. Whereas doctors showed greater medical knowledge, nurses were better at the techniques. Both were equally deficient in defining hypertension. We therefore set up a short course (3h) in blood pressure measurement to evaluate knowledge and provide further training. The course consisted of a pretest, a short training programme and a post-training test. Post-training test results showed an average improvement in defining hypertension from 5% to 85%. We conclude that short-term training courses in blood pressure measurement are needed for nurses and doctors, particularly young doctors. We also need more coverage in the medical press to stimulate interest in this vital topic.