Nurse titration clinics to achieve rapid control of blood pressure

To assess the effectiveness of a new hypertension clinic (in Auckland, New Zealand) using clinical nurse specialist appointments for drug titration.

A new hypertension clinic was established at Waitemata District Health Board (DHB) in August 2010 using an initial registrar clinic appointment followed by fortnightly clinical nurse specialist appointments for drug titration. 50 GP-referred patients were prospectively audited and their outcomes compared to 50 patients seen in the physician hypertension clinic.

The comorbidities of the two groups were similar. 52-66% had the metabolic syndrome by IDF criteria. The mean number of clinic visits to discharge was not significantly different. The mean number of antihypertensive drugs at discharge was the same (2.8) for both clinics. There were significant reductions in systolic and diastolic blood pressures in both clinics, with a mean discharge blood pressure of 131/78 in the nurse clinic group.

Nurse titration clinics are as effective as physician-only appointments in rapidly achieving target blood pressures.