Increased blood pressure (BP) is the leading risk factor for death and disability globally, 1 with more than 40% of the adult population older than 25 years having hypertension.2 Although much of hypertension is preventable, especially by reducing the amount of salt added to foods, hypertension treatment can also prevent the adverse consequences of stroke, heart attack, and heart and kidney failure.2 Unfortunately, about half of patients with hypertension remain undiagnosed. Hence, the World Hypertension League has made the increase in regular BP assessments and encouragement of widespread BP screening programs linked to diagnosis and clinical management of hypertension to be among the highest of priorities.Whether in low-, middle-, or high-resource settings, recommendations for BP assessment are consistent and include a standardized approach to pre-measurement preparation, patient positioning, appropriate cuff selection and placement, measurement technique, and use of accurate BP-measuring devices.4-9 For BP-measuring devices, there is typically a choice between manual devices using the auscultatory technique and either semi-automated (manual inflation) or fully automated (automated inflation) devices using oscillometry.

Objective:To characterize the factors that interfere in drug treatment compliance in a group of individuals with arterial hypertension.Methods:A non-experimental descriptive study that analyzed a sample of 80 patients diagnosed with arterial hypertension, who underwent medical treatment and were admitted to a university hospital during the period from March to May 2009. To collect data, the Instrument for Evaluation of Attitudes Regarding Taking Medication was applied.Results:In the studied population, 45.1% had sufficient degree of compliance to drug therapy. Individuals with controlled blood pressure, females, white, single, married or widowed, retired, aged between 40 and 59 years, and those aged above 80 years were the interviewees who answered positively regarding compliance and follow-up of drug therapy.Conclusion:Despite the fact that the number of factors that facilitate the process of compliance to drug treatment is greater than the number of complicating factors, we found that more than half of the patients surveyed had an insufficient degree of compliance with drug treatment for high blood pressure, which demonstrates the need to develop studies aimed to identify these factors and their contribution to the promotion of patient autonomy, acceptance, awareness and adaptation regarding their illness.

Permanent educational activities aiming at standardizing blood pressure measurement should be implemented among the different categories of health professionals.

The greater prevalence of chronic diseases like systemic arterial hypertension among elderly people results in an increase of drugs use. Therefore, the incidence of a lot of drug-related problems (DRP) rises, and this leads to many health problems in the population. Based on literature, authors emphasize the multidisciplinary team approach (physicians, nurses and pharmacists) to activities directly related with pharmacotherapy for hypertension, granting elderly persons a better comprehension about taking care of their own health, to reduce DRP and achieve satisfactory adherence.

Hypertension is one of the most important risk factors for cardiovascular disease. The Global Burden of Disease Study in 2010 described hypertension as the leading risk factor for global disease burden, accounting for 18% of all deaths and 7% of global disabilityadjusted life years.1 Furthermore, hypertension is responsible for 45% of deaths caused by ischemic heart disease and 51% of deaths caused by stroke. As the leading risk for death and disability, hypertension requires a global response. Reducing uncontrolled blood pressure (BP) by 25% is one of nine United Nations targets to reduce noncommunicable diseases (NCDs) by 2025. 3 To that end, hypertension was the feature of World Health Day in 2013.2 The effort to reduce uncontrolled BP is based on two distinct, but integrated, approaches. One is to lower population BP through efforts such as reducing the amount of salt consumed, and the other is to identify people at risk for vascular disease and to clinically manage their hypertension to reduce global cardiovascular risk. 4 The task of clinically managing increased BP globally is daunting. In 2008, 40% of the global population older than 25 years had hypertension, representing approximately 1 billion people. 5 Further, the burden of hypertension is greatest where resources are the lowest. For example, the African region has a hypertension prevalence rate of 46% in adults older than 25 years, compared with the Americas, which have a prevalence rate of 35%. 4 In Haiti, the prevalence rate of hypertension in men and women older than 40 years is 69.1% and 67.2%, respectfully.7 Despite the high burden, awareness, and treatment, control rates are suboptimal in most developing countries, which are disproportionately impacted by hypertension. This also underlines the "know-do gap" in terms of transfer of evidence to policy and practice.Simplistically, the sequential steps to the clinical management of hypertension are: (1) the identification of people whose BP is high; (2) behavioral lifestyle counseling; (3) assessing vascular risk to identify those in whom pharmacologic interventions are cost-effective; (4) prescribing the indicated pharmacologic therapies to reduce vascular risk; and (5) titrating pharmacologic and lifestyle behavior therapy to achieve recommended risk target levels. 8,9 In most low-resource settings (LRS), the current major initial barrier is the identification of people whose BP is high.

To avoid inaccurate blood pressure (BP) readings, the American Heart Association (AHA) recommends cuff width (CW)

To assist hypertension control programs and specifically the development of training and education programs on hypertension for healthcare professionals, the World Hypertension League has developed a resource to assess knowledge, attitudes, and practices on hypertension management. The resource assesses: (1) the importance of hypertension as a clinical and public health risk; (2) education in national or international hypertension recommendations; (3) lifestyle causes of hypertension; (4) measurement of blood pressure, screening, and diagnosis of hypertension; (5) lifestyle therapy counseling; (6) cardiovascular risk assessment; (7) antihypertensive drug therapy; and (8) adherence to therapy. In addition, the resource assesses the attitudes and practices of healthcare professionals for task sharing/shifting, use of care algorithms, and use of registries with performance reporting functions. The resource is designed to help support the Global Hearts Alliance to provide standardized and enhanced hypertension control globally.

Objective To determine and to analyze the theoretical and practical knowledge of Nursing professionals on indirect blood pressure measurement.Methods This cross-sectional study included 31 professionals of a coronary care unit (86% of the Nursing staff in the unit). Of these, 38.7% of professionals were nurses and 61.3% nurse technicians. A validated questionnaire was used to theoretical evaluation and for practice assessment the auscultatory technique was applied in a simulation environment, under a non-participant observation.Results To the theoretical knowledge of the stages of preparation of patient and environment, 12.9% mentioned 5-minute of rest, 48.4% checked calibration, and 29.0% chose adequate cuff width. A total of 64.5% of professionals avoided rounding values, and 22.6% mentioned the 6-month deadline period for the equipment calibration. On average, in practice assessment, 65% of the steps were followed. Lacks in knowledge were primary concerning lack of checking the device calibration and stethoscope, measurement of arm circumference to choose the cuff size, and the record of arm used in blood pressure measurement.Conclusion Knowledge was poor and had disparities between theory and practice with evidence of steps taken without proper awareness and lack of consideration of important knowledge during implementation of blood pressure measurement. Educational and operational interventions should be applied systematically with institutional involvement to ensure safe care with reliable values.