The nurse practitioner's role in complex patient management: hypertension.

The importance of hypertension as a risk factor and the size of the hypertensive population have created a demand for care of this problem. Nurse practitioners are effective managers of simple hypertension; however, high blood pressure often coexists with other chronic illnesses. Data are not yet available to support the role of the nurse practitioner in the management of more complex patients. The authors have examined the characteristics of patients and the processes and outcomes of care in a hypertension clinic in which physicians and nurse practitioners share responsibilities for patient care. The results show that the nurses are managing patients as complex as those seeing only physicians and are achieving better blood pressure control. The nurses successfully identify important problems and refer appropriately. Thus, nurse practitioners, with physician support, can serve as primary managers for even complex patients. Use of this model will significantly increase the resources available for care of hypertension.