<p>Nurse practitioners have the opportunity to improve the detection and enhance the management of hypertensive patients and those susceptible to coronary heart disease (CHD). For example, primary care initiatives would help to meet the Health of the Nation target (DoH 1992) of a 40 per cent reduction in the number of strokes in England and Wales by the year 2000. The nurse practitioner could improve significantly the quality of life for the hypertensive patient and his or her family by preventing the catastrophic effects of a stroke. There would also be significant financial savings for the NHS.</p>