Date of Award

Spring 5-27-2017

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Joseph Burkard, DNSc, CRNA

Second Advisor

Jian Hua Liu, PhDc, RN

Third Advisor

David Bittleman, MD


Analyses of hypertensive confounding factors were identified by looking retrospectively at patient demographics, medications, recent blood pressure and the medical history of hypertensive patients with diabetes. The data trends found in this database highlighted potential areas for improvement with regards to the care of patients with this co-morbidity in the outpatient setting. All prescription anti-hypertensives prescribed for the 102 patients followed the National Joint Committee (JNC-8) Hypertension Guideline Algorithm. Of 102 adult males (over the age of 18), 22 patients had a blood pressure that is out of control (over 140/90). Within this group of patients, 33.3% of the patients are overweight with a body mass index between 25.0 and 29.9. Patients were obese 60.8% of the time with a BMI of 30.0 and above. Half of the patients (51 of 102) have an active diagnosis of obstructive sleep apnea. There is a need for continued aggressive treatment of hypertension in order to keep blood pressure below the recommended 140/90mmHg per the JNC-8 Hypertension Guidelines for hypertensive and diabetic patients. Several evidence-based practice recommendations were provided to address the clinically significant findings mentioned above.

Included in

Nursing Commons