The Pros And Cons Of Hypertension

From the researches, it is common wisdom that uninsured adults reported overall health, compared to the individuals who were enrolled in medical insurance facilities like the Medicaid. They are less likely to report multiple health conditions. However, the reason behind the number of uninsured individuals reporting less issues of hypertension is the fact that most of these issues go unnoticed. These conditions were more likely undiagnosed and uncontrolled. The research found out that about 80% of the uninsured adults had an uncontrolled condition, compared to the 63.4% of the insured adults. This shows that technically, uninsured adults had more issues with hypertension, only that they were not diagnosed and their conditions are not

There is broad evidence that Americans often do not get the care they need even though the United States spends more money per person on health care than any other nation in the world. Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or self management services to help them more effectively manage their conditions.

Oklahoma’s leading cause of death is cardiovascular disease. Overall, Oklahoma ranks number 48 in having the highest amount of cardiovascular disease-related deaths. We are the third worst in the nation, only being beat by Alabama and Mississippi. (Americas Health Rankings, Oklahoma State Data, 2014) In 2013, Oklahoma had a total of 9,703 deaths from cardiovascular disease. Heart disease accounts for 29.6% of all deaths in Oklahoma. Overall, out of every 100,000 people who die in Oklahoma, 252 of those people died from cardiovascular disease. (Oklahoma State Department of Health, “Vital Statistics”,2013) In comparison, in 2009, the latest year recorded, California had a total of 58, 801 cardiac related deaths out of 231,764. The percentage

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 National Guideline Clearinghouse provides information on clinical practice guidelines and the US Preventive Task Force provides recommendations for screenings and counseling based on the patient’s gender, age, race, etc. Both supply information for disease prevention and evidence based clinical practices that providers can use daily while caring for their patient. The recommendations and guidelines that are provided on the AHRQ website are ever evolving as new information becomes available thus allowing providers to keep up with current practice. The days of providing care based on “this is how it has always been done” are gone. The AHRQ guidelines and recommendations is the go-to website for medical providers looking to provide best care for their patients by following evidence based

Atul Gawande, a public health researcher, has a similar yet different opinion to high cost health care. His article narrates a story about his investigation in McAllen, TX, a city which has the highest cost of health are in the United States. Gawande explains that the high cost of health care in McAllen was largely responsible for overutilization of resources through the FFS payment method.

There is evidence that Americans often do not get the care they need. This is alarming because the United States spends more money per person on health-care than any other nation in the world. Health care in the United State is not used as effectively as it should be used; this results in higher spending on complex and chronic diseases. Patients who suffer from hypertension, heart disease, and diabetes often do not receive the health care and effective treatments such as drug therapies or self management services to help them more effectively manage their conditions. People with these diseases need more than medicine; they need the treatment and health education to help them know and understand their disease and be able to live a more healthy lifestyle. This is true for insured,

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

According to a recent Centers for Disease Control and Prevention (CDC) (2016) report, one out of three Americans suffers hypertension (HTN), and that accounts for 75 million or 29% of the adult population in the United States (U.S). All told, hypertension costs America 48.6 billion dollars in health care expenditures, medications, and missed days of work among the American population (CDC, 2016). According to the Texas Health Data (2013), death rate among 26,448,193 residents of Texas, 170.1 deaths are related to hypertensive heart disease (HHD). The AHRQ (2013) health expenditure data demonstrates that the southern region of the United States, which includes Texas, exceeded the average health expenditure of $805 per hypertensive person.

Machado et al. did not address the scope of the problem or consequences of the problem in the problem statement. However, these items were identified in the introduction leading up to the problem statement as complications of uncontrolled HTN with low rates of adherence to treatment associated with advanced age and disparaging public health factors (Machado et al., 2017). The problem is identified as systemic arterial hypertension (SAH) requiring treatment changes that might be difficult to institute or maintain for the elderly population due to various factors (Machado et al., 2017). Machado et al. briefly address the background and knowledge gaps as aspects related to culture, the health environment and individual capacities (2017). A proposed solution is introduced in the problem statement to build a relationship with the HTN patient to with the patient in corroborating on a plan of care that the patient is able understand and will follow through with (Machado et al.,

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.

Table 2 shows WBCs count /cmm and differential leukocytic percentage(mean± SD) of control and essential hypertension patients. It has been found that the WBCs counts (7138±1444) and differential leukocytic percentage of neutrophils (60.385±9.014),eosinophils (6.86±1.573) and monocytes (7.154±1.519)of patients were higher than those of controls.

Mrs. A (pseudonym) is an 83-year-old Samoan female of Christian religion who was admitted to an urban hospital on 02/04/15 by GP referral. She came in with chest pain associated with productive cough and shortness of breath (SOB) on exertion. She also complained of having recurrent episodes of vomiting mixed with saliva and fatigue. She has a history of asthma, hypertension, type 2 diabetes mellitus on Metformin and double incontinence due to a long-standing history of intermittent constipation. Her chest computed tomographic (CT) revealed right lower lobe opacity indicating pulmonary consolidation, which means that her right lower lung has accumulated exudates in the alveoli that would have normally been filled by gas, indicative of bacterial pneumonia. Furthermore, a sputum gram stain sample collected from Mrs. A showed gram-positive bacteria, which is also a characteristic of pneumonia. Her blood tests revealed a high haemoglobin count, which may be caused by an underlying lung disease, as well as high white blood cell count confirming the presence of infection. Considering all diagnostic results, Mrs. A was diagnosed with right lower lobe bacterial pneumonia.

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).

Hypertension is defined a consistent elevation of the systolic blood pressure above 140mmHg, a diastolic pressure above 90mmHg or a report of taking antihypertensive medication. Early diagnosis and effective management of hypertension is essential because it is a major modifiable risk factor to cerebrovascular, cardiac, vascular, and renal diseases. The higher the blood pressure, the greater the risk for heart attack, heart failure, stroke, and kidney disease.