Recognition and management of hypertension by nurses: action in patients with diabetes is critical.

Dorothy Morris, Donna McLean, Jo-Anne Costello, Lyne Cloutier
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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.

护士对高血压的认识和管理:糖尿病患者的行动至关重要。
加拿大高血压教育计划(CHEP)、加拿大高血压协会、加拿大血压协会、加拿大糖尿病协会、加拿大家庭医生学院、加拿大药剂师协会、加拿大心脏病和中风基金会以及加拿大心血管护士委员会最近发布了一项呼吁,呼吁加拿大所有的卫生保健专业人员加倍努力,帮助糖尿病患者维持目标血压(Campbell等人,2009b)。糖尿病患者的血压(B/P)应低于收缩压130毫米汞柱,舒张压80毫米汞柱(CHEP 2009)。考虑到糖尿病患者高血压的识别和治疗可以减少残疾和死亡,控制高血压必须成为一个跨学科的优先事项。维持B/P低于130/80 mmHg需要改变生活方式作为治疗的基础,通常需要两种或更多种B/P药物(Campbell等,2009a)。糖尿病患者控制B/P所需的多种药物的费用是估计可以降低总体健康成本和相关心血管疾病并发症的少数治疗方法之一(Gillies, Abrams, & Lambert, 2007)。护士是评估和协助糖尿病患者和所有高血压患者降低整体心血管风险的重要伙伴。护士也可能是评估和监测患者在坚持生活方式或药物干预方面的困难的关键从业人员(Jayasinghe, 2009;McLean et al., 2008)。建议个体化的生活方式咨询和治疗调整,以维持目标B/P,治疗糖尿病患者的血糖异常、血脂异常、吸烟或任何其他心血管风险。
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