Hypertension : An Abnormal Elevation Of Blood Pressure

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

Because hypertension can be asymptomatic, it is necessary to increase awareness of such a harmful condition. The lack of symptoms in individuals who have high blood pressure is a serious challenge that public health officials in the United States must face. [1]. High blood pressure is a grave problem in the United States because it affects many

The concern on whether anti-hypertensive’s should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure.

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

Hypertension is sometimes referred to as the silent killer (Aycock, Kirkendoll, & Gordon, 2013). Today it is a public health problem. According to the American Heart Association 2013 Statistical Fact Sheet (2013), one out of every three adults has high blood pressure, which is estimated at 77.9 million people (AHA, 2013). High blood pressure is also referred to as hypertension. Hypertension is a prevalent medical condition that carries with it the risk factor for increased chances of heart disease and stroke (Gillespie & Hurvitz, 2013). Hypertension remains one of the top 10 causes of worldwide disability-adjusted life years (as cited in Drenjančević-Perić et al., 2011). For the estimated 348, 102 deaths in 2009, high blood pressure was listed as the primary or contributing cause of death (AHA, 2013). Despite the health risk associated with hypertension, the diagnoses of high blood pressure continue to rise. By 2030, hypertension is expected to increase by 7.2% from 2013 estimates (AHA, 2013).

The following section is broken into six subsections that will assess how each topic relates to JNC 6, 7, and 8. The subsections are organized into the following: algorithms, classification of hypertension, lifestyle modifications, pharmacological treatment, and management of care. It is important to note that JNC 6 and 7 have a greater correlation in format and the types of recommendations presented to clinicians. Contrastingly JNC 8 varies in format, as well as the type of recommendations presented to clinicians, therefore each of the subsections may not contain information on JNC 8.

In Monmouth County, it has been documented that the stroke mortality rate among older adults “between 2011 and 2013 was 32.3 deaths per 100,000 population”, which is comparable to the statewide rate (“2016 Community Health Assessment,” 2017). Buonacera, Stancanelli, & Malatino (2017) have stated that “hypertension is the leading modifiable contributor to stroke.” Therefore, it is important to focus on monitoring the blood pressure (BP) and detect early signs of hypertension, due to high BP, to prevent the development of stroke. One of the Leading Health Indicators (LHI) priorities from Healthy People 2020 that I will concentrate on is “HDS-5.1 Reduce the proportion of adults with hypertension” (“Heart Disease and Stroke,” 2014). Researchers have indicated that 35.9% of older adults have been diagnosed with high blood pressure in 2015. It indicates a significant increase since 2011 than the desired target of 26.9% suggested by Healthy People 2020 (“2016 Community Health Assessment,” 2017; “Heart Disease and Stroke,” 2014). The prevalence of hypertension in Monmouth county is alarming. Health promotion and preventative measures should be implemented to reduce the percentage of older adults with hypertension, accounting for more CVD mortality than other modifiable

Over the past years, heart disease has constituted one of the leading causes death in America. In fact, statistics show that one in every seven deaths is as a result of heart-related diseases (American Heart Association, 2016). Conversely, most deaths reported are of elderly individuals aged above the 65 years. However, there are also other underlying conditions that elevate the risk of developing heart diseases. According to the American Heart Association (2016) 62% of men and 67.8% of women have high blood pressure that are aged between 65-74 years of age. High blood pressure exposes older people to high-risk chances of developing cardiovascular diseases, characterized by high rates of mortality, morbidity, and disability. Cardiovascular

Hypertension related research could be assessed using meta-analyses and randomized control trials. A combination of both will be used for this narrative review, since all three have been useful in determining JNC guidelines. Much of the research conducted has been on different interventions that include lifestyle and pharmacological treatment that have been used to reduce blood pressure and control hypertension. JNC 6 focused its efforts on improving dietary habits to avoid developing hypertension or manage it once diagnosed. JNC 7 appears to be an intermediate of the other two guidelines. It contains information on the lifestyle modifications as well as pharmacological treatment. JNC 8 is formatted quite differently that the other two and appears to be geared towards proper and prompt diagnoses of the disease, as well as forms of treatment.

As late as about seven decades ago, elevated blood pressure was considered by many expert physicians to be necessary for the adequate perfusion of vital organs. It was deemed as an unavoidable, hence essential, component of the aging process leading to the coining of the term “essential hypertension”. High blood pressure (BP) was considered as probable natural and necessary compensatory phenomenon that should be left alone even if there were effective treatments (Hay, 1931; White, 1937). This notion was further strengthened by the observed elevated misery and premature death recorded for the patients that were treated for hypertension with the few drugs that were available at the time compared to those that were left untreated (Goldring,

Hypertension is one of the leading risks for heart disease and stroke. Your physician may advise dietary or lifestyle changes, or specific medications to lower your blood pressure.

These are three of the leading causes of death in the United States (United “High” 1). Over 68 million individuals have increased possibilities of suffering from one or more of these perilous causes of death (United “High” 1). There is a large population of Americans that are not even aware that they have hypertension.

In the US, high blood pressure is second to smoking as the largest number of preventable heart ailments and stroke deaths. According to a big government-sponsored research of hypertensive patients aged 50 and above, death from heart-related causes in 2015 went down 43 percent, while heart failures declined 38 percent when patients lowered their blood pressures below 120 as against the old target of below 140.

Approximately one in every three adult’s ages 20 years old and older are diagnosed with high blood pressure or hypertension. Hypertension affects 78 million people in the United States and is equally prevalent in both men and woman (Crabtree et al., 2013). Hypertension is a major risk factor for cardiovascular disease (Hajjar & Kotchen, 2003). It can lead to stroke, myocardial infarction, renal failure, heart failure, neurological issues, and death if not detected early and not treated properly (James, Oparil, Carter, & et al., 2014). Approximately 9.4 million deaths in 2010 were attributed to high blood pressure (Angell, De Cock, & Frieden, 2015). About 54% of strokes, 47% of coronary heart disease, and 25 % of other cardiovascular diseases are attributed to high blood pressure (Arima, Barzi, & Chalmers, 2011).

The two major types of hypertension are primary and secondary. Primary hypertension accounts for more than 90% of all cases and has no known cause, although it is hypothesized that genetic factors, hormonal changes, and the altercations in sympathetic tone all may play a role in its development. Secondary hypertension develops as a consequence of an underlying disease or condition. The prevention and treatment of hypertension is a major public health issue. When blood pressure is controlled, cardiovascular, renal disease, and stroke may be prevented. The JCN, reported more than 122 million individuals in American are overweight or obese, consume large amounts of dietary sodium and alcohol, and do not eat adequate amounts of fruits and vegetables; less than 20% exercise regularly. Both modifiable and non-modifiable factors play a role in the development of hypertension