"Beyond the Blood Pressure Reading: The Pivotal Role of Community Health Nurses in Hypertension Detection, Prevention, Treatment Support, and Long-Term Control"

Abstract: Hypertension is one of the most important modifiable risk factors for cardiovascular disease, stroke, chronic kidney disease, heart failure, and premature mortality. Despite the availability of inexpensive diagnostic methods and effective antihypertensive therapies, substantial gaps remain in hypertension awareness, treatment initiation, adherence, follow-up, and sustained blood pressure control. Global evidence indicates that the number of adults living with hypertension has increased markedly, while many affected individuals remain undiagnosed or inadequately treated [1,2]. Because hypertension is frequently asymptomatic, community-level detection and continuous follow-up are essential components of an effective public health response. Community health nurses occupy a strategically important position in this continuum because they can combine clinical assessment, health education, behavioural counselling, family engagement, medication-support activities, home visits, referral, follow-up, and coordination with primary healthcare teams. Evidence from nurse-led interventions demonstrates that structured nursing care can contribute to improvements in blood pressure and cardiovascular risk-factor management [3,4]. Community-based programmes involving trained health workers have also demonstrated improvements in hypertension screening, identification, monitoring, and medication adherence, particularly in resource-constrained settings [5,6]. In India, initiatives such as the India Hypertension Control Initiative demonstrate the value of standardized treatment protocols, team-based care, patient-centred approaches, reliable medication supply, and information systems [7]. This narrative review examines the role of community health nurses in hypertension detection and control, including screening, accurate blood pressure measurement, risk assessment, lifestyle modification, medication adherence, home-based care, referral, digital health, documentation, family participation, and programme monitoring. The review also discusses barriers, professional competencies, ethical considerations, and future directions for strengthening nurse-led hypertension services within primary healthcare.