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护士对高血压的识别与管理:对糖尿病患者采取行动至关重要。

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

作者信息

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

机构信息

Vancouver Island Health Authority (Royal Jubilee Hospital), Victoria, BC

出版信息

Can J Cardiovasc Nurs. 2009;19(4):4-12.

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.

摘要

加拿大高血压教育项目(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、加拿大心脏与中风基金会以及加拿大心血管护士理事会最近呼吁加拿大所有医疗保健专业人员加倍努力,协助糖尿病患者维持目标血压(坎贝尔等人,2009年b)。糖尿病患者的血压收缩压应低于130 mmHg,舒张压应低于80 mmHg(CHEP,2009年)。鉴于认识和治疗糖尿病患者的高血压可减少残疾和死亡,控制高血压必须成为跨学科的优先事项。将血压维持在低于130/80 mmHg需要以生活方式改变作为治疗的基石,并且通常需要两种或更多种降压药物(坎贝尔等人,2009年a)。糖尿病患者控制血压所需的多种药物成本是估计可降低总体医疗成本及相关心血管疾病并发症的少数治疗方法之一(吉利斯、艾布拉姆斯和兰伯特,2007年)。护士是评估和协助糖尿病患者以及所有高血压患者降低总体心血管风险的重要合作伙伴。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困难的关键从业者(贾亚辛赫,2009年;麦克林等人,2008年)。建议进行个性化的生活方式咨询和治疗调整,以维持目标血压,并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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