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In his article, “Hypertension Guide May Affect 7.4 Million”, Gina Kolata observes that approximately two-thirds of American aged above 60 years are likely to server from hypertension. This is supported by the fact that; there are so many people who are admitted to various hospitals suffering from hypertension. Some people have also been admitted to various nursing homes where they are on receiving with medication (Kolata, 2013, December 19).
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A good example is H.K., who is 80 years old widow female. She was born in India and she only speaks one language, Punjabi. H. K was admitted to a nursing home on 06/07/2013 due to depressive disorder requiring assistance with ADL’s. She is on DNR code status and no allergies.
I believe she chose for DNR code given that she is at her advanced age. However, it is worth nothing that the decision for a DNR code is not the easiest one any person can make in their lives. Under these instructions, it is evident that H.K treatment only involves the treatment of symptoms that are as a result of pain or rather shortness of breath to just facilitate comfort. This however does not in any way prolong her life. Given her condition, H. K is actually suffering from hypertension.
In reference to the case study above, this paper will be giving a comprehensive and consistent facts about hypertension. In support of these facts, this paper will majorly focus on various aspects of the disease.
In particular, the paper will be looking at the anatomy and physiology as well as the risk factors that are associated with hypertension. In addition, this paper will also mention the signs and symptoms, diagnostics, treatment and complications of this disease. Moreover, this paper will go further and indicate how the disease process affects the body system, the nutrition information that is necessary for the patients as well as the required planning and teaching on patient discharge.
Commonly known as high blood pressure, hypertension is a prominent blood pressure which clinically is considered to be higher than 140/90 mm/Hg. Once blood pressure in the arteries is high then the heart has a big task of pumping blood throughout the blood vessels (Culpepper, 1983). Basically, the two types of blood pressure that are measured include systolic and diastolic measures.
Systolic measure is done when the heart contracts after a beat in order to let blood out of the ventricular while diastolic measure takes place during the relaxation of the ventricular, and thus, being filled with blood. Hypertension occurs when there is an increase resistance of blood flow, even though the cardiac effects remains the same.
High blood pressure is normally classified into two; essential/primary hypertension and secondary hypertension. In comparison of these two, primary hypertension does not need any serious medical attention but then a lot of consideration must be channeled towards secondary hypertension because it can result to various effects on the body (Wylie, 2005).
There are many pathophysiology mechanisms that are involved in the development of primary hypertension. These include peripheral resistance as well as cardiac output. These two are responsible for arterial pressure. Meanwhile, heart rate and stroke volume are the two determinant of cardiac output. Stroke volume is also influenced by two factors. These include; myocardial contractility in conjunction with the vascular compartment. On the other hand, peripheral resistance occurs as a result of the structural changes of the arteries and arterioles (CEACCP, n.d.).
Numerous diseases have many risk factors that in one way or another contribute or rather lead to these diseases. Likewise, there a number of risk factors that are known to be associated with hypertension. Some of these factors includes;
This is one important risk factor that is associated with hypertension. The more advanced in terms of age an individual becomes, the higher the chances of developing hypertension.
Men forms the large portion of high blood pressure as opposed to females
Individuals who engages in a lot of exercises and who are more active in their old age are less likely to server from hypertension as compared to those people who are in an inactive physically.
Salt has been found to have a higher impact of contributing to high blood pressure
Smoking is a risk factor in many diseases. Likewise it is also a risk factor and can contribute to hypertension. So people are highly encouraged to quit smoking.
Even though research is still being done to confirm the preliminary indications that, an individual who comes from a family which has been diagnosed with hypertension has a high probability of suffering from this disease (Guyton & Hall, 2006).
There are a number of signs and symptoms that are associated with high blood pressure. However, it is important to note that there are no direct symptoms that solely can be considered or linked to hypertension. The situation is even made difficult by the fact that most signs that can be deemed to associate with high blood pressure can also result from normal blood pressures. Some of these symptoms include; fatigue, dizziness, nose-bleeding as well as severe headache (Hypertension, n.d).
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As it can be observed, the above symptoms also occurs in other diseases as well. So when these symptoms start showing up, a person suffering from high blood pressure will also shows some other signs such as vomiting, restlessness, having a blurred vision as well as shortness of breath.
Hypertension can now be more suspicious if a person shows other signs like, variation in the mental abilities that is characterized by being confused and eventually leading to a coma. Other signs that will indicate hypertension includes having a heart attack or heart failure, experiencing a lot of pain in the chest, fluids in the lungs, and severe swelling of the brain (Hypertension, n.d). These symptoms are also accompanied by kidney failure, damage of the brain, heart as well as the eyes.
There are many examinations that can be used to indicate if a patience with above mentioned symptoms and signs is suffering from high blood pressure. The first step is to measure the blood pressure levels. This is done through a series of steps as indicated below;
- A patient is required to sit down with both feet on the floor for at least five minutes. The patient’s arm should also rest peacefully on the arms of the examination chair.
- Once the patient is sited relaxing on the chair, a cuff that is attached to the dial is then rubbed around his/her arm. It is important to note that it is the upper arm and not the lower arm. The purpose of dial is actually to show or rather indicate the level of blood pressure.
- The responsible professional who in most cases is the nurse pumps the cuffs so that blood flow can be stopped. Once this is done, the nurse slowly and carefully loosens the cuff and with the aid of a stethoscope the nurse listens to the blood pressure particularly in the elbow. This is what is refereed to systolic measurement of blood pressure.
- Eventually the nurse loosens the cuff further and blood start flowing normally until the heart beat cannot be heard through the elbow. This is what is called the diastolic tests.
- If through these test, there is a convincing indication that indeed the blood pressure of the patient is high, then definitely the doctor will indicate that the patient should return for two to three more similar tests so that the blood pressure can be confirmed (Hypertension, n.d).
There are other tests that can be carried out to supplements the tests above. These include; the test for glucose, urine examination, blood tests for determination of potassium levels as well as examination of the kidney functionality (Black, 1999).
Generally, there are two approaches that can be used to treat hypertension. These include; change of lifestyles as well as well as the use of medicine.
There are a number of lifestyle changes that can be adopted and help in dealing with high blood pressure. These include; (a) try as much as possible to reduce body weight. This is because it has been found that high blood pressure is directly proportion to the rate of increase of body weight. In addition, losing weight allows the various medication that are taken to work more efficiently and effectively (b) eating a well-balanced diet that is rich of fruits with reduced salt and fats (c) being active in participating various physical activities. These activities should be undertaken on a daily basis and not just on the weekends (d) reduce alcohol, caffeine as well as tobacco as much as possible (e) avoid all forms of pressure or stress in this case because actually they tend to increase the level of blood pressure (Diseases and Conditions, n.d).
Hypertension can also be treated medically using the following drugs; the use of beta-blockers to reduce rate at which the heart beats, use of angiotensin, Diuretics and alpha1-adrenergic (Hypertension, n.d).
There are numerous complications that may occur due to hypertension. The major common ones include; thickening of blood vessel, this will lead to coronary heart disease, heart failure because of exhaustion of the heart due to the increased load of pumping blood, hypertension also increases chances of cardiac arrhythmias.
Hypertension can also lead to stroke as well as diabetes as a result of some drugs that are used to treat it. Men are likely to suffer from sexual dysfunction while females who have high blood pressure have been found to have problems during pregnancies. In addition, blood vessels that supply the brain may be damaged leading to dementia (Simon, 2013)
One of the most affected body system as a result of hypertension is the circulatory system. This is because, when the heart pumps blood too fast, it may rupture capillaries and arteries (Simon, 2013).
The digestive system is also affected by high blood pressure. This results due to the fact that, capillaries and arteries are responsible for supplying the stomach with the necessary blood for digestion to take place but once they have been damaged, then the stomach which is part of digestive system is not able to carry its functions well (Simon, 2013).
The nerves system is also affected by high blood pressure. This occurs due to the fact that arteries are responsible for supplying blood to the brain. If they get damaged due to the high blood pressure from the heart then the functions of the nerves system are impaired and this may definitely lead to dementia (Gregson, 2001).
The endocrine system actually has a great contribution to secondary hypertension. This is because, hyperaldosteronism, Cushing’s syndrome as well as pheochromocytoma which are endocrine diseases have been found to contribute to high blood pressure (Gregson, 2001).
The respiratory system is also affected by high blood pressure because of the damage that may be caused to the kidney. Poor material flow to muscle tendons as the functionality of different blood vessels is impaired will lead to adverse effects on the muscular system (Gregson, 2001).
The major consideration of nutrition is to try and reduce weight. Thus eating more fish, foods which contain fiber, vegetables and fruits is an ideal diet for patients suffering from high blood pressure. In addition all daily fat products should be avoided. Moreover, foods that are rich in calcium, magnesium and potassium are also highly recommended. On top of that, avoid red meet at all cost but then white meet from turkey and chicken is recommendable (Culpepper, 1983).
Once a hypertension patient has been discharged, it is better for him/her to follow some guidelines which in this case include; taking medicines as directed by the physician, being taught to know the facts of the disease. This will assist the patient to prepare himself psychologically and in the process avoid all forms of stress which may arise.
Another important thing that the patient must observe also is to constantly engage in various physical activities. This will also help the patient decrease his blood pressure. The patient also needs to be keen with regard to the foods he will be taking and try to avoid a lot of salt as well as any fat related foods (Diseases and Conditions, n.d).
An important fact also the patience should be taught is some symptoms like severe headache, weakness in lower or upper arm, trouble when breathing and difficulties when speaking. Once the patient has experienced these signs, he should call for help immediately
BJA: CEACCP. (n.d.). Hypertension: pathophysiology and treatment. Retrieved March 3, 2014, from http://ceaccp.oxfordjournals.org/content/4/3/71.full
Black, E. R. (1999). Diagnostic strategies for common medical problems (2nd ed.). Philadelphia: American College of Physicians.
Culpepper, W. S. (1983). Cardiac anatomy and function in juvenile hypertension. The American Journal of Medicine, 75(3), 57-61.
Diseases and Conditions. (n.d.). 10 ways to control high blood pressure without medication. Retrieved February 27, 2014, from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974?pg=2
Gregson, S. R. (2001). High blood pressure. Mankato, Minn.: LifeMatters.
Guyton, A. C., & Hall, J. E. (2006). Textbook of medical physiology (11th ed.). Philadelphia: Elsevier Saunders.
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Kolata, G. (2013, December 19). Hypertension Guide May Affect 7.4 Million. The New York Times. Retrieved March 3, 2014, from http://www.nytimes.com/2013/12/20/health/hypertension-guide-may-affect-7-4-million.html?_r=0
Moore, R. (2001). The high blood pressure solution a scientifically proven program for preventing strokes and heart disease ([2nd ed.). Rochester, VT: Healing Arts Press.
Simon, H. (2013, June 27). Health Guide. High Blood Pressure. Retrieved March 2, 2014, from http://www.nytimes.com/health/guides/disease/hypertension/complications.html
Wylie, L. (2005). Essential anatomy and physiology in maternity care (2nd ed.). Edinburgh: Elsevier, Churchill Livingstone.
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