Date of Award
Doctor of Nursing (ND)
Hector R. Morales, DNP, APRN, PHH/CS-BC
Background and Local Problem: Hypertension is one of the leading causes of heart disease globally, nationally, and locally in El Paso, TX. An estimated 1.28 billion people are affected by this disease, including at least 30% of the El Paso population.
Objective: The objective of this project is to apply evidence-based practice to decrease blood pressure readings of 140/90 mmHg and above, by at least 10 mmHg systolic or diastolic.
Methods and Interventions: A ten-day reflective practice assessment was conducted resulting in the identification of suboptimal blood pressure control with blood pressure readings of 140/90 mmHg and above. This was done using a monotherapy anti-hypertensive agent such as Hydrochlorothiazide 12.5 mg–25 mg or Lisinopril 10 mg–20 mg, daily. A literature review was conducted to review the ability of evidence-based treatment to lower blood pressure readings ≥140/90 mmHg by at least 10 mmHg systolic or diastolic, effectively, and safely. The use of dual or combination anti-hypertensive agents such as Lisinopril 10-40 mg and Amlodipine 2.5-10 mg, for blood pressures above 140/90 mmHg was shown to reduce systolic or diastolic blood pressure by at least 10 points, thereby achieving optimization in a timely manner.
Results: Three patients were treated with dual anti-hypertensive medications. All three had a decrease of >10 mmHg in either systolic or diastolic pressure.
Conclusion: The use of dual anti-hypertensive medication is effective in reducing blood pressure by at least 10 mmHg systolic or diastolic; hence, blood pressure control can be achieved in a timely manner.
Tuiafono-Blocker, Salalau R., "Dual Hypertensive Medication Therapy for Initial Treatment of hypertension with BP greater than 140/90" (2023). Cohort XI. 9.