Hypertension is a widespread disease process and well-known risk factor for coronary artery disease, stroke, heart failure, and renal failure. Proper diagnosis and treatment of hypertension is crucial to reducing these adverse patient outcomes. The Eighth Joint National Committee (JNC 8) released their most recent guidelines of the diagnosis and management of hypertension in December 2013 with implementation to take effect in January 2014. The JNC 8 guidelines of hypertension include the following: proper diagnosis of hypertension (>140/90 for patients < 60 years of age and those with diabetes and/or chronic kidney disease and >150/90 in patients > 60 years of age), lifestyle modifications to be initiated with every hypertensive patient, and newly diagnosed hypertensive patients should follow-up one-month after initial diagnosis and treatment. It is important for primary care providers to abide by these recommendations because of the evidence-based research behind the guidelines released by the Eighth Joint National Committee. This study is significant to education, nursing, and further research because of the prevalence of hypertension. This study was a quantitative, retrospective chart review that analyzed electronic medical records of adult patients newly diagnosed with hypertension with or without diabetes and/or chronic kidney disease. Following approval by the Institutional Review Board (IRB), a standardized data collection tool and legend was used to collect information such as: age, gender, race/ethnicity, blood pressure classification according to the JNC 8 guidelines, diagnosed comorbidities of diabetes and/or chronic kidney disease, pharmacologic management of hypertension, one-month follow-up with the primary care provider, documented need of lifestyle modifications, type of primary care provider and insurance of the patient. A total of 328 patients’ charts met the researchers’ criteria of 18 years of age or older and newly diagnosed with hypertension after January 1, 2014 for inclusion in the study. After compiling the data, the researchers determined the majority of primary care providers do follow the JNC 8 guidelines to diagnose and treat hypertension. Also, in congruence with the JNC 8 guidelines, pharmacological therapy was initiated for each patient diagnosed with hypertension. There was significant statistical difference in recommendation of lifestyle modifications in patients with comorbidities, and diet modifications was the most common lifestyle modification utilized by primary care providers. While primary care providers are likely to follow the JNC 8 guidelines in diagnosing and initiating pharmacological treatment in hypertensive patients, this study concluded that primary care providers do not educate on all recommended lifestyle modifications of the JNC 8 guidelines which include healthy diet, weight control, regular exercise, and smoking cessation
Master of Science in Nursing (MSN)
Dr. Teresa Hamill
Dr. Sueanne Davidson
Dr. Brandi Lambert
Stidham, Emily J.; Hillhouse, Meagan Z.; Murphy, Haley J.; Parker, Shelly R.; Ponder, Elaina A.; and Tutor, Lauren A., "Implementation of the Eighth Joint National Committee Guidelines of Hypertension By the Primary Care Provider" (2018). MSN Research Projects. 1.