The Gap Analysis Of Hypertensive Heart Disease

K.H. is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and stethoscope with her in the hope of learning to take her husband’s blood pressure at home.

Hypertension, also known as high blood pressure, has become a major risk factor for several types of heart disease across the globe. In the United States alone, nearly 70 million adults have been diagnosed with this condition [1]. Hypertension is a condition in which arterial walls experience extreme force from blood flowing through; long-term force against artery walls will lead to more serious health problems such as stroke, renal failure, and other cardiovascular diseases [2]. If the proper steps to treat hypertension are not taken, patients have a high risk of developing atherosclerosis, a condition that causes arteries to harden significantly. Smoking, obesity, lack of physical activity, high alcohol consumption, and high sodium intake are factors that may cause an individual to be diagnosed with hypertension [3] Detection of hypertension is crucial in order to reduce the incidence of death by cardiovascular disease [1].

Texas ranks number one with the highest uninsured rate in the nation, accounting for nearly 6 million people (1). The federal government has nearly $100 billion for Medicaid expansion, out of which $15 billion is needed for expansion in Texas (1). Opting out of Medicaid expansion has left 1.5 million eligible Texans without health insurance (2). Consequently, a 300 percent increase in costs for primary care services, being provided in the emergency department, has been observed (1). Similarly, most hospitals are facing nearly $3-5 billion in losses due to uncompensated care (1).

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.

Hederson, S., Princell, C. O., and Martin, S. (2012, December). The patient-centered medical home. American Journal of Nursing, 112(12), 54 59. doi: 10.1097/

Cardiovascular disease is the leading cause of death in the United States and is responsible for 17% of the national health expenditure (Heidenreich et al., 2011). In 1985, cardiovascular disease accounted for 10% of the gross domestic product. However, this number increased to 15% in 2008. Meanwhile, the expenses related to cardiovascular disease have increased

Heart disease, also known as cardiovascular disease (CVD), is the leading cause of death in the world (World Health Organization [WHO], 2016). A depressing number of Americans are diagnosed with heart disease every year at 11.5% (Center for Disease Control and Prevention [CDC] 2016a). With 1 in every 4 deaths being from heart disease, the national age adjusted death rate of 167 and over half of the deaths are from men, we can see that heart disease is a serious problem (CDC, 2016b; CDC, 2016c). Oklahoma is no exception, with a CVD related death rate of 228.1 (CDC, 2016d). Community and individuals are dependent upon the demographics and qualities of that community to determine their health. Currently, Oklahoma faces a number of issues that affect overall health, including cardiovascular health of the entire state and the included communities. Therefore, this paper will analyze CVD statistics in Oklahoma, compare data and demographic features to Minnesota, and discuss lifestyle risks related to Healthy People 2020.

In the fourth reviewed on the impact of hypertension treatment to low­income groups, and the challenges this medical cost posed to them. A federal qualified health center (FQHC) in Michigan provides care to the medically underserved and people in the low­income group. This center sampled 212 of their patients and looked at their history of having hypertension or currently has hypertension. It shows that the FQHC had a high percentage of patients who had an uncontrolled blood pressure. The high percentage of patients with uncontrolled high blood pressure at the FQHC could be attributed to the fact that the patients cannot afford the treatment

Mancia G, Omboni S, Parati G. Assessment of anti-hypertensive treatment by ABP. J Hypertens 1997, 15 (Suppl.2): 543-50.

As previously mentioned, cardiovascular disease has developed to become the major cause of deaths across the world. A cohort study and evidence-based management study was developed to identify the major causes of the disease, analyze key steps, including current medications used to address the disease, and identify ways for mitigating is proliferation. The study was based

Several classifications of drugs were enumerated in the brochure with corresponding actions, side effects, and appropriate interventions, however, an example of the drug name for each class would be beneficial to the public. Correlating drug name to disease condition will perhaps, trigger the public to adhere to the treatment regimen. When examining the listed classifications of drugs, an inaccurate or incomplete detail was found in the description of the action of central agonist drugs, centrally acting agents stimulates the brain, specifically the alpha-adrenoceptors thus, lower blood pressure and causes bradycardia (Van Zwieten, 1980). In the brochure, there was no mention of bradycardia, as one of the effects of the central agonist drugs, which is alarming due to the fact that the majority of the American people takes multiple medications. Another key point to remember as part of disease prevention is recommending pill organizer to the elderly or watch alarms to promote compliance in taking prescribed

The goals of Healthy People 2020 include preventing cardiovascular diseases and improving the quality of life by preventing, detecting, and managing any risk factors responsible of cardiovascular diseases and stroke (Healthy People 2020, 2013). The objectives of Healthy People 2020 include increasing the proportion of adults with prehypertension who meet the recommended guidelines for sodium intake, and increasing the proportion of adults with hypertension who meet the recommended guidelines for sodium intake (Healthy People 2020, 2013). Advance Nurse Practitioners (ANP), and Primary Care Providers (PCP) are usually the first provider who see a new patient requiring medical attention or who need a routine physical examination. It is their responsibility to elaborate and follow up a plan of care that includes curative, preventive and educational strategies. ANPs may identify people diagnosed with prehypertension and hypertension and promote change in their life style. In the same way, it will be very beneficial to incorporate some approaches or interventions to decrease the sodium intake in patients with self-reported hypertension (Ayala, Gillespie, Cogswell, Keenan, & Merritt, 2012).

Creating awareness on the treatment and control of hypertension is primary health promotion concern in Howard County Maryland, Columbia. Hypertension involves making lifestyle changes to control risk factors; a teaching plan is best suited for the county?s case. Nurses and Nurse Practitioners have the decisive role in preventing and managing hypertension using patient education and counseling (Neutel & Campbell, 2009). The nurses are the first providers to see new patients when they come to the hospital or visit their healthcare providers. As a student nurse, I obtained subjective and objective data from patients, implement a plan of treatment with my preceptor. We communicate and collaborate with the nurse managers and physician, then outlines and evaluate a care plan with primary and secondary prevention on hypertension strategies for the patients.

In a standardized manner, information was obtained on relevant socio demographic characteristics like age, gender, drug history and history of hypertension and DM with the aid of an interviewer – administered semi – structured questionnaire. The weight (taken with patients in light clothing) and height (without cap/head gear/shoes) of the patients were measured using a stadiometer. The body mass index (BMI) was then calculated using the formula; BMI = weight (in Kg)/height (m2). BP was measured according to the recommendations of American Society of Hypertension.5 The average of two readings taken 15 minutes apart was recorded.

In today’s current society, everyone is becoming more health conscious. Behind every corner, there is a disease or disorder that is ready to wreak havoc on our systems, promising death. People are starting to fight back. However, many are unaware of one pathological condition that has the ability to sneak into people’s lives like a thief in the night. People continue on living, oblivious to the changes going on inside them, only noticing a change once plenty of damage has been done. This is hypertension. Its silence is what makes it so deadly, countless fall victim every year.