Management of Patients With Hypertension: A Hypertension Clinic Model

To describe a successful system for managing outpatients with hypertension. The establishment of a Hypertension Clinic in the Division of Hypertension at the Mayo Clinic was reviewed. The assignment of responsibilities in the use of a team approach was evaluated, and the various types of patients encountered were compared. Our experience has shown optimal control of hypertension in outpatients with use of a team approach, including hypertension medical specialists, nurses, dietitians, and nurse-educators. Patients also assume an active role in their own care, particularly for compliance with medications and recommended lifestyle changes, attendance at the Hypertension Clinic for follow-up monitoring, and reporting of symptoms or side effects of drugs. Individual goals are established, and patients are managed by the nurse-clinicians. The physician reviews each patient's course at regular intervals or as needed for specific situations. Short-term patients, long-term patients, and those undergoing liver transplantation have successfully participated in this type of a program. The team approach for management of outpatients with hypertension effectively provides a support system for prompt attention to any questions or medical problems that arise. With such an approach, decreased morbidity and mortality from hypertension and associated cardiovascular disease have been achieved.