Physician-nurse team approaches to improve blood pressure control.

Hypertension is an asymptomatic chronic disease that contributes to the development of serious health problems including coronary artery disease, chronic renal failure, and stroke. Despite published guidelines addressing goals for the treatment of hypertension, control rates (defined as a blood pressure <140/90 mm Hg) have not increased in recent years, and uncontrolled hypertension remains a serious public health issue. Both patient- and provider-related factors contribute to these poor control rates, and new approaches to the management of hypertension must be sought. In this review, we describe unique physician-nurse team approaches to improve the control of hypertension both in a subspecialty hypertension practice and in a primary care clinic setting. By implementing practice models that result in sustainable improvements in blood pressure control rates, the morbidity and mortality resulting from target organ damage and ensuing costs to society may be expected to decline as well.