The aim of this paper is to create awareness through education about hypertension, which is common among adults. Some of the issues that will be covered include etiology, signs and symptoms, at-risk population, prognosis, diagnostic procedures, treatment protocols as well as pharmacological treatments.
Definition
Hypertension refers to the blood pressure (BP) that is above 140/90 – it becomes severe when the pressure is above 180/120. Hypertension is diagnosed in individuals when, in two consecutive days, their systolic BP is ≥140 mmHg and/or the diastolic BP is ≥90 mmHg. In simpler terms, Blood pressure occurs when the force of blood between the arteries and the wall is constantly high (DeGuire et al., 2019). Elevated BP is when systolic is 120 to 129 mm Hg and diastolic is 80 – normal BP is 120/80 mm Hg and below.
Etiology
It is important to note that most cases of hypertension are categorized as essential hypertension. Research shows that an increase in salt intake is a major cause of hypertension (Oh et al., 2020). One of the widely described factors for the development of essential hypertension is the “genetic ability to salt response” (Oh et al., 2020, p. 5). Oh et al. (2020) further added that about 60 percent of patients tend to be salt-sensitive and, as such, may develop hypertension. Genetic to salt response means that anything that is above the required amount– increases the blood pressure. In other words, an increase in the intake of salt is directly proportional to hypertension.
Causes of Hypertension
It is imperative to note that hypertension develops over time. It may occur as a result of unhealthy lifestyle choices such as lack of physical activity. In addition to this, other health conditions, such as diabetes and obesity, may increase the risk of developing high blood pressure. Diet and lifestyle are regarded as two of the main contributors to essential hypertension. Secondary hypertension is established when a direct cause of high blood is identified. The most common causes of secondary hypertension are kidney disease and tumors – adrenal glands secret excess hormones.
Signs and Symptoms
Hypertension is regarded as one of the most unpredictable health conditions because it is not easy to diagnose – some people may not even know they have it. According to DeGuire et al. (2019), a third of the population with high blood pressure is not aware of the illness – it does not have “any symptoms unless it is very severe” (p. 15). This explains why healthcare professionals recommend regular check-ups. In fact, those who have a relative with this condition are advised to monitor their BP at home.
At Risk Population(s)
The at-risk population for hypertension varies with sex and age. Adults are the most affected population – about 23 percent of adults Americans above 50 live with hypertension (Rab et al., 2020, p. 597). As for women, 75 percent of those above 75 years have hypertension (Rab et al., 2020). However, of men aged 75 years, 64 percent of them suffer from hypertension (Rab et al., 2020, p. 598). African Americans tend to experience hypertension at an earlier age. The last at-risk population for consideration is pregnant women.
Prognosis
The prognosis of hypertension largely depends on how well it is managed and controlled. For those patients who follow a prescribed diet and assigned physical activities, they will be able to control it (Rabi et al. (2020). For example, patients should follow a strict and healthy lifestyle pattern comprising up to 30 minutes of daily exercise, intake of a low-salt diet, and taking prescribed medication daily. Prognosis depends on several features such as level of blood pressure, presence of target-organ changes, co-existing risk factors, and age at presentation.
Diagnosis of High Blood Pressure
The diagnostic process of high blood pressure requires regular check-ups. The healthcare provider will examine the patient by asking them a set of questions about their medical history and possible symptoms. The provider will use a stethoscope to listen to the heartbeat. Similarly, a cuff that is placed around the arm will also aid with checking blood pressure (refer to the diagram in the slide). It is important to ensure it fits well for accurate reading. The cuff, as elucidated by DeGuire et al. (2019), “is inflated using a small hand pump or a machine” (p. 15). During the initial visit, the care provider will measure blood pressure in both to find out if there are any variations – a higher reading will be used in the subsequent checking.
Tests
Once diagnosed with high blood pressure, the healthcare provider may recommend several tests to determine a cause. The first test is ambulatory monitoring, which is a longer test performed to check blood pressure (Zhang et al., 2021). The second test is lab tests, which target blood and urine to check for possible conditions that can cause or increase the severity of the condition. The last test is an electrocardiogram (ECG or EKG), which is used to measure how fast or slow the heart is beating and associated electrical activity.
Treatment Protocols
In an effort to treat hypertension, the care provider will recommend non-pharmacological and lifestyle management. This is necessary for individuals with elevated BPs regardless of gender, age, and cardiovascular-related risks. Education should contain detailed instructions on weight, salt intake, and regular exercise (Valenzuela et al., 2021). Weight management is helpful if obesity is present. Weight reduction tends to lower systolic blood pressure by up to 20mmHg. Smoking management is necessary to prevent the development of cardiovascular conditions. Lastly, lifestyle changes are necessary as they decrease the chances of developing high BP.
Pharmacological Treatments
The type of medication used to treat hypertension depends largely on the severity of the blood pressure. According to Rabi et al. (2020), many healthcare providers recommend a combination of two or more drugs to effectively manage the condition. Before one starts taking any medication, it is important to have well-established goals, such as reducing BP. Those above 65 and living with other diseases, such as diabetes and chronic kidney are advised to aim for a BP lower than 130/80 mmHg (Rabi et al., 2020). The recommended pharmacological treatment options are angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), and diuretics.
Support Systems
Maintaining a healthy diet that is low in sodium and saturated fats and taking medication as prescribed require having a support system. It is important for patients with hypertension to have a team that will help with planning healthy meals, preparing the right food and drink, and, at the same time, encouraging them to remain on track with their goals. Therefore, having a support system comprising health professionals from different disciplines helps a lot with accomplishing the set goals. The system may include primary care providers, nurses, pharmacists, and social workers who use their skills to help patients.
Prevention
It is imperative to note that by preventing high blood pressure, one essentially lowers the risk of developing other complications such as stroke and heart disease. This presentation recommends the following healthy living habits in an effort to prevent high blood pressure. Firstly, individuals should strive to eat healthy diets such as plenty of fresh fruits and vegetables, which maintain BP to normal. Secondly, patients should strive to maintain a healthy weight, which helps reduce the risk of developing hypertension. One way of determining weight is by calculating the body mass index once weight and height are known (Unger et al., 2020). Lastly, patients should constantly take part in physical exercises, which helps a lot with maintaining a healthy weight. Physical Activity Guidelines for Americans website is a good place to start.
References
DeGuire, J., Clarke, J., Rouleau, K., Roy, J., & Bushnik, T. (2019). Blood pressure and hypertension. Health Report, 30(2), 14-21. Web.
Oh, G. C., & Cho, H. J. (2020). Blood pressure and heart failure. Clinical Hypertension, 26(1), 1-8. Web.
Rabi, D. M., McBrien, K. A., Sapir-Pichhadze, R., Nakhla, M., Ahmed, S. B., Dumanski, S. M., & Daskalopoulou, S. S. (2020). Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Canadian Journal of Cardiology, 36(5), 596-624. Web.
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., & Schutte, A. E. (2020). 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334-1357. Web.
Valenzuela, P. L., Carrera-Bastos, P., Gálvez, B. G., Ruiz-Hurtado, G., Ordovas, J. M., Ruilope, L. M., & Lucia, A. (2021). Lifestyle interventions for the prevention and treatment of hypertension. Nature Reviews Cardiology, 18(4), 251-275. Web.
Zhang, W., Zhang, S., Deng, Y., Wu, S., Ren, J., Sun, G., & Cai, J. (2021). Trial of intensive blood-pressure control in older patients with hypertension. New England Journal of Medicine, 385(14), 1268-1279. Web.