Hypertension: The Silent Killer Essay

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.

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute

D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and

The percent change in spending for heart disease was attributed to a 68.6% increase in cost per treated case and a 30.3% increase in the population treated. Heart disease spending was the largest among 15 medical conditions experiencing the largest rise in spending. Interestingly, the rise in cost per treated hypertension case accounted for 60% of the overall growth in spending for hypertension compared with a 19% rise in treated prevalence of the disease. This was attributed to the emergence of new and more costly antihypertensive drugs. In contrast, 50% of the rise in health care spending for diabetes was a result of a rise in treated prevalence and only 24% was attributed to an increased cost per treated case. The total spending for diabetes increased from $8.6 billion in 1987 to $18.28 billion in 2000. Spending for diabetes will surely rise exponentially in the next 10 years because of the continued increase in prevalence of the population being treated and an increased cost per case as new diabetic drugs enter the pharmacologic armamentarium. The spending for diabetes and the spending for heart disease are obviously intertwined.

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.

Hypertension is a developing problem worldwide associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%,

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 uninsured patients of hypertension are less likely to report having hypertension because they cannot afford to seek a healthcare provider and if they access the doctor then they were not able to meet the drug prescription cost. This situation makes the uninsured patients to be more prone to unawareness of their health condition. Despite the benefits that accompany the treatment of hypertension, the overall cost of treatment is overwhelming. The cost of the treatment and the cost of the pharmaceutical products needed are relatively high. Improving policies that encourage cost effectiveness may improve treatment of these disorders. Additionally it may maintain equity as the costs of medication and medication can be predetermined. Several measures may improve better health to individuals. They include insuring with privately run and public medical insurance institutions. They include Medicare and Medicaid. Insured non­elderly individuals, compared with uninsured individuals showed a greater potential of receiving drug therapy. This is the case in the elder insured and uninsured. Age and gender had a significant impact on one’s ability to access medical cost and care if they were diagnosed with

High blood pressure AKA Hypertension is inflicting damage to the guts, kidney, and brain, despite the fact that there are not any visible indicators noticed nor the patient feels no symptoms.

Lastly, blood pressure is associated with ones diet and lifestyle. It is amazing when one’s diet consist of a high intake of salt they will shows signs of hypertension. Studies have shown that people who did not use salt shown no signs of hypertension. Monitoring the intake of salt will improve blood pressure readings drastically although; it is not the only contributor to high blood pressure. Increasing activity levels has also been known the lower blood pressure readings.

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 widely considered to be one of the most important risk factors of cardiovascular diseases (angina, arrhythmia, etc.). It is the second leading disease that causes mortality in the world. Hypertension is the condition when there is an increase in the force of blood on the walls of vessels. It can also be defined as an arterial blood pressure that is raised above 140/90 mm Hg (systolic/ diastolic BP). Hypertension can be classified into Secondary hypertension and Essential hypertension. When specific cause is evident but heredity, and various physiological parameters play a role in increasing blood pressure is known as Essential Hypertension. Secondary Hypertension is one where the cause is known. According to WHO guidelines between 2006 and 2015, deaths due to cardiovascular diseases are expected to increase by 17% while the deaths from infectious diseases, nutritional deficiencies, maternal and prenatal conditions are projected to decline by 3%. The main causes of hypertension includes the age ,hereditary, gender, extra weight, alcohol consumption, stress life, lazy life etc.

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