Multisociety Jordan National Hypertension Registry (JNHR) Initiative-Entry Form
Multisociety Jordan National Hypertension Registry (JNHR) Initiative-Entry Form
A Collaborative Program of Nine Jordanian Medical Societies Coordinated by the Jordanian Cardiac Society (JCS)
Participating Societies
• Jordanian Cardiac Society (JCS)
• Jordan Atherosclerosis Society (JAS)
• Jordan Society of General Practitioners (JSGP)
• Jordan Society of Internal Medicine (JSIM)
• Jordan Society of Nephrology (JSN)
• Jordan Society of Family Medicine (JSFM)
• Jordan Emergency Medicine Society (JEMS)
• Jordan Endocrine and Diabetes Society (JEDS)
• Jordan Nutrition Society (JNS)
Jordan National Hypertension Registry – Primary Care Entry Form
(This form can be filled in 2 minutes)
Section A – Patient Identification (Auto-filled if possible)
• Registry ID (auto)
• Age
• Sex
• Date of visit
• Known HTN (Yes / No)
• Newly diagnosed (Yes / No)
Section B – Blood Pressure
• Office BP (average of 3 readings): __ / __
• Home BP available? (Yes / No)
• ABPM done? (Yes / No)
BP category:
• Controlled
• Stage 1
• Stage 2
• Severe (≥180/120)
Section C – Risk Factors (tick boxes)
□ Diabetes
□ CKD (eGFR <60)
□ Dyslipidemia
□ Smoker
□ Obesity
□ Family history premature CVD
□ Known ASCVD
□ Heart failure
Section D – Labs (last available)
• eGFR: ____
• UACR done? (Yes / No)
• LDL-C: ____
• HbA1c (if diabetic):
Section E – Medication
Current therapy (tick):
□ ACEi
□ ARB
□ CCB
□ Thiazide
□ MRA
□ Beta-blocker
□ SGLT2i
□ Single-pill combination
Adherence:
• Good
• Partial
• Poor
Section F – Acute Events (since last visit)
□ Severe HTN episode
□ Hypertensive emergency
□ ACS
□ Stroke
□ Pulmonary edema
□ Hospital admission
Section G – Outcome
• Target achieved (<130/80)? Yes / No
• Next follow-up date:
