Jnc's Six Subsections

The population of interest in the proposed evidence-based project includes adults; (i) with a primary diagnosis of hypertension (values >140/90 mmHg or a mean daytime systolic BP of130 mm for diabetic patients), (ii) aged 18 years or over, and (iii) able to express themselves in written or spoken English. Patients with a diagnosis of end-stage renal disease, severe cognitive impairment or any other form of illness that would make their participation in the quality improvement

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.

Blood pressure measurements on adult males 30-39 years of age were obtained in a survey of a representative sample of Twin Cities households. To compare the frequency of hypertension in the white and non-white population surveyed, the most appropriate measure is the

Primary hypertension can be linked to several risk factors, some in which are evident in K.H.’s history and

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 predominantly a major problem for African Americans whose occurrence percentages are amongst the highest in the world (Heckler, Lambert, Leventhal, Leventhal, Jahn, & Contrada, 2008). Even though there have been meaningful progress in treatment of hypertension, the number of patients with well managed high blood pressure condition remain worryingly low, with the latest trends suggesting a high rise in the number of uncontrolled high blood pressure cases. This is

According to JNC 8 guidelines, close monitoring is essential when patients start on new hypertensive medication. Therefore, Mr. Hightower will require frequent visits to the clinic to ensure improvement in his health condition. His blood pressure will be monitored at each visit and blood work will be done to monitor his kidney and liver functions and to determine his adherence to treatment. In case of noncompliance, a third category of antihypertensive must be added to improve hypertension outcomes and prevent cardiovascular disease.

JNC 8 has a hypertension guideline algorithm. Patients older than 60 should be placed on pharmacological treatment if SPB is 150 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 150/90 Patient less than 60 should be placed on pharmacological treatment if SPB is 140 mm Hg or higher and DBP is 90 mm Hg or higher. Target goal is 140/90. Initial drug of choice for nonblack patients is an ACEI, ARB, thiazide or CCB alone or in combination. Black patients should be started on a thiazide or CCB alone or in combo. It is recommended to start one drug titrate to maximum dose and then add another drug if target goal has not been achieved. Combination therapy is recommended if BP is greater than 20/10 mm Hg from target. I also gives a guideline for all ages if the patient is diabetic without kidney disease or the patient has kidney disease without diabetes (Armstrong, 2014).

High blood pressure increases your risk for heart disease and stroke, two leading causes of death for both Florida and the United States (Centers for disease control, 2017). High blood pressure, also called hypertension, is known as the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it. Hypertension damages blood vessels in the organs, reducing their ability to work properly (National institute of diabetes and digestive and kidney diseases, 2016). About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure. Only 54% of these people have their high blood pressure under control (Centers for disease control, 2017). Hypertension education, which focuses on controlling the disease with medication, diet, and losing weight, is important in preventing or delaying the progression of serious complications. Most people diagnosed with hypertensive disease will need to see a medical professional who will recommend lifestyle changes to help you control and prevent high blood pressure (Ignatavicius & Workman, 2006, p. 1742).

According to a systematic review by James et al. (2014) on several RCT, there is strong evidence of the advantage of treating people aged 60 above with a blood pressure threshold of 160/90 and people aged less than 60 years with a threshold of 140/90 mmHg. This study also reported that there is moderate evidence to support HCTZ, ACE or ARB as the first line therapy for the nonblack hypertensive population to control hypertension and prevent cardiovascular events. This study also concluded with a strong evidence of starting thiazide diuretics as first-line therapy for black hypertensive patients (James et al., 2014). An RCT study by Krones et al. (2008) demonstrated that shared decision making (SDM) increased patient satisfaction and lowered decisional regret.

The Hill-Bone Compliance for hypertension treatment (Culig & Lapper, 2014) will be utilized project to assess the behaviors of the patients in three significant domains of hypertension treatment (1) taking medication (2) decreasing sodium in the diet (3) keeping of their appointment. This measuring scale questionnaire has fourteen items in three subscales, and each question has four Likert form of answer (Culig & Lapper, 2014). The Hill-Bone compliance This measure has been tested for validity and reliability, and was found to be clinically valuable for identifying noncompliance issues and to envisage blood pressure status (Kim, Hill, Bone, & Levine, 2000).

The data for the study was collected through home interviews and clinical examinations. Patients had their blood pressure measured six times total (three in the home

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).

Lifestyle Modification for the Prevention and Treatment of Hypertension - 2003, Page vi by Jiang He, Patricia M. Kearney, Paul K. Whelton, Paul Muntner, Jeremiah Stamler, Norman M. Kaplan, Shiriki Kumanyika, Nayyar Iqbal, Jeffrey A. Cutler, Eva Obarzanek, Edward J. Roccella, Ian B. Puddey, Kazuko Ishikawa-Takata, Toshiki Ohta, Francesco P. Cappuccio, Lawrence J. Appel, Lawrence J. Beilin, Trevor A. Mori, Thomas Pickering, Mohammad Rafey, Elaine Urbina, Jeff D. Williamson, William B. Applegate, Daniel W. Jones, Marion R. Wofford, Edward D. Frohlich. | Online Research Library: Questia. (n.d.). Retrieved October 13, 2017, from https://www.questia.com/read/110137349/lifestyle-modification-for-the-prevention-and-treatment

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