Hypertension

Abstract

Hypertension is a severe medical condition that affects many people worldwide. Usually, hypertension does not project significant medical symptoms; however, it is linked with other diseases such as kidney failure, heart failure, vision loss, and dementia. The level of hypertension is determined by two measurable values: the diastolic pressure and the systolic pressure. Systolic pressure represents the higher pressure as a result of the heart forcing blood into the arteries, while diastolic pressure represents when the heart refills blood. Hypertension is often considered a silent killer as significant symptoms rarely accompany the condition. According to the world health organization, the medical condition is a significant cause of premature death worldwide, with over 1 billion people having the disease. Most patients are unaware of the medical condition or the possible symptoms. High blood pressure is caused by a complex set of environmental factors and genetic interactions. Although there are no particular identifiable causes of hypertension in adults, advancement in age and the risk of developing hypertension in life is a crucial factor. A large number of people around the world are affected by high blood pressure are a result of poor lifestyle choices. It is essential to make the right lifestyle changes to reduce the severity of hypertension by maintaining healthy body weight within the recommended body mass index and control other contributing factors. Besides, early detection and management of hypertension can significantly lower the adverse side effects and the potential risk of diseases and death.

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Hypertension

Introduction

Hypertension is a severe medical condition with a progressive increase in the level of blood pressure in blood vessels. Although the state may not display symptoms, it significantly increases the risk of other diseases such as kidney failure, heart failure, vision loss, and dementia. Blood pressure is the force caused by blood pushing against the arterial wall as it flows throughout the body. The amount of resistance in arteries and the volume of blood pumped by the heart causes an increase in blood pressure(Giles et al., 2009). Therefore, narrow arteries and high volumes of blood cause a direct increase in blood pressure. The condition is classified as either primary or secondary hypertension. Primary hypertension accounts for between 90 to 95 percent of all reported cases, caused by either genetic disorders or an unspecified lifestyle of patients. These lifestyle factors include alcoholism, smoking, body overweight, or excessive use of salt in the diet. Secondary hypertension accounts for the remaining 5 to 10 percent, which is caused by a specific identifiable cause (Giles et al., 2009). These causes include endocrine disorder, the use of birth control, and constriction of kidney arteries. According to the World Health Organization, the condition is a significant cause of premature death worldwide, with over 1.2 billion people having the condition (WHO, n.d).

Purpose of the Paper

From the rates provided above, it is evident that hypertension is a menace globally, with a significant number affected by the condition. As such, this paper seeks to enlighten the reader regarding the aspects surrounding the condition. The article highlights the causes of hypertension including lifestyle factors like alcoholism, smoking, obesity, or excessive use of salt. It also delves into the secondary causes that comprise of endocrine disorder, the use of birth control, and constriction of kidney arteries.

The level of blood pressure is determined by two measurable values: the diastolic pressure and the systolic pressure. Systolic pressure represents the higher pressure when the heart forces blood into the arteries, while diastolic pressure represents when the heart relaxes to refill blood. Systolic readings often fall between 100 and 130 millimeters mercury (mmHg) and between 60 t0 80 mmHg for diastolic pressure. An adult patient is considered to have high blood pressure if the blood pressure readings are persistently above 140 mmHg for systolic and 90 mmHg for diastolic measurements. In the case of children, the ambulatory blood pressure is monitored for 24 hours to reduce the white coat hypertension effect (Kaplan, 2010).

Hypertension is often considered a silent killer because significant symptoms rarely accompany the condition. Most patients are unaware of the states or the possible symptoms; hence, it is usually identifiable through screening or when seeking medical help for other conditions. Patients commonly report nose bleeds, nausea, headaches, vertigo, tinnitus, or loss of visions; however, these symptoms are inconclusive and may be related to other conditions such as anxiety. On a physical examination, significant changes in the optic fundus directly correlate with the severity and duration of the hypertension condition. Besides, other identifiable symptoms such as hyperthyroidism, Cushing’s syndrome, and renal artery stenosis may suggest secondary cases of high blood pressure. Hypertensive crisis refers to highly elevated blood pressure levels, usually above 110 mmHg diastolic and 180 mmHg systolic. Hypertensive cases often signify significant organ damage within the body, causing breathlessness, chest pains, and drowsiness (Kaplan, 2010). If there is no organ damage, the condition is often treated using oral blood pressure medication. Moreover, hypertension cases are reported in 8 to 10 percent of pregnancies due to a pre-existing condition or pre-eclampsia (Kaplan, 2010). Therefore, the best way to detect instances of high blood pressure is through the examination of a qualified medical practitioner using standardized equipment. Besides, individuals can measure blood pressure levels using automated devices available in the market.

High blood pressure is caused by a complex set of environmental factors and genetic interactions. Although there are no particular identifiable causes of primary hypertension in adults, advancement in age, and the risk of developing hypertension in life is significant. Other contributing factors include a high intake of salt, obesity, and lack of physical exercise play a considerable role. Moreover, deficiency of vitamin D and the consumption of caffeine are some of the contributing factors, although the relationship is not clearly defined. Maternal smoking, low birth weight, and lack of breastfeeding in the early life of children may be risk factors contributing to the development of hypertension in later life. Secondary hypertension is a result of a range of identifiable medical conditions. These are Conn’s syndrome, hypothyroidism, and atherosclerosis. Other causative factors include excessive alcohol consumption, sleep apnea, obesity, prescription medicines, cocaine, and several cases of depression (Kaplan, 2010).

Furthermore, there are various genetic characteristics of patients that cause small and significant effects on blood pressure levels, especially in the renin-angiotensin-aldosterone (Kaplan, 2010). The primary function of the system is to produce hormones that regulate blood pressure, and salt levels, any change on the genetic code of this system can cause variation in blood pressure. Furthermore, cases of hypertension tend to be hereditary; if a parent diagnosed with the condition, then there is a high chance for the offspring to developing the same disease.

Uncontrolled hypertension condition gradually deteriorates the body, thus leading to life-threatening complications. Due to the increased blood pressure, the arterial lining gets damaged. Also, the high blood pressure and the constant shrinking of the arterial wall causes an aneurysm, which can cause rupturing blood vessels. High blood pressure strains the heart muscle leading to an enlarged heart and heart failure. Hardened arteries can cause a disruption of blood supply to the brain leading to cases of mild cognitive impairment, stroke, and dementia. Moreover, it causes kidney failure, visual impairment, and sexual dysfunction (Hermida et al., 2013).

A large number of people affected by high blood pressure are a result of lifestyle choices. Therefore, it essential to make lifestyle changed to reduce the severity of the condition by maintaining a healthy body weight within the recommended body mass index and reduce the consumption of salt. Also, it is vital to engage in physical exercise, eat a diet with a lot of fruits and vegetables, and minimize alcohol consumption. A lifestyle change can significantly lower blood pressure levels, similar to a person on antihypertensive medication (Hermida et al., 2013).

Hypertension causes pregnancy complications such as eclampsia and gestational; these complications account for between 6 to 8 percent of maternal and fetal morbidity. Therefore, the management of hypertension in mothers seeks to prevent significant cardiovascular events without affecting fetal development (Veerbeek et al., 2015). The treatment options include control of acute hypertensive conditions and the management of chronic hypertension. For elderly hypertensive patients, reduction in sodium consumption, incorporation of a diet full of fruits, and regular aerobic exercise reduce the blood pressure levels to a manageable point. Analysis of different treatment trails for elderly patients shows that anti-hypersensitive treatment reduces cardiovascular-related deaths by 17.5 percent, stroke by 30 percent, and total mortality by 13 percent (Veerbeek et al., 2015). The past two decade has seen a prevalence of pediatric hypertension due to an increase in the number of overweight children. Therefore, it is recommended to start monitoring the blood pressure of children starting from 3 years old. Weight loss and intake of fruits and vegetables and regular physical activity will prevent additional pharmacologic therapy. Furthermore, children with hypertension have limited access to a particular type of sports activities that may not worsen the situation.

Resistant hypertension is an uncontrollable blood pressure condition that is poorly responsive to treatment; hence, it needs the use of various therapies to regulate. This condition may be a result of poor adherence to antihypertensive prescriptions, an inappropriate combination of drugs, primary aldosteronism, and possible organ failure. Other factors include excessive consumption of salts, which, in effect, reduce the effectiveness of antihypertensive medications (Daugherty et al., 2012).

Implementation of Nursing Practice

As portrayed above, lifestyle choices are the most common causes of high blood pressure. Apart from eating habits, the condition is caused by lack of physical activity. Therefore, this paper advocates for implementation of more nurse-led hypertension clinics. According to Nirmala Markandu, a hypertension specialist, nurses play a significant role in managing the condition (Markandu, 2017). Over the years, nurses specializing in hypertension have increased with the aim of raising awareness and averting other ailments associated with the state. Therefore, increasing nurses who are experts in hypertension will aid in managing the same. In this case, BP care will be enhanced, more clinics initiated as nurses heighten patient care, which involves detection, referral, prescribing, and managing medications (Markandu, 2017).

Effective treatment and management of hypertension conditions need the effort of medical personnel and the patients to balance both clinical and non-clinical procedures to control high blood pressure. Various experts have produced systems used to manage and treat high blood pressure cases by ensuring pressure levels range between 140 to 160 mmHg systolic and 90-100 mmHg for patients. Patients with diabetes or chronic kidney diseases have a lower target range of 150/90 mmHg (Krause et al., 2011). A reduction in blood pressure levels in patients by 5mmHg can lower the risk of stroke by 33 percent.

In conclusion, an increase in blood pressure as it is pumped throughout the body causes hypertension. The rise in blood pressure is a potential risk factor that may lead to several medical conditions or even death. High blood pressure can be prevented through medication and lifestyle changes that lower blood pressure levels. The treatment of patients with hypertension requires a combined approach of physiology and pharmacology medication while taking into account the various variations of hypertension and their causes.

 

References

Daugherty, S. L., Powers, J. D., Magid, D. J., Tavel, H. M., Masoudi, F. A., Margolis, K. L., … & Ho, P. M. (2012). Incidence and prognosis of resistant hypertension in hypertensive patients. Circulation, 125(13), 1635-1642.

Giles, T. D., Materson, B. J., Cohn, J. N., & Kostis, J. B. (2009). Definition and classification of hypertension: An update. The Journal of Clinical Hypertension, 11(11), 611-614.

Hermida, R. C., Ayala, D. E., Fernández, J. R., Mojón, A., Smolensky, M. H., Fabbian, F., & Portaluppi, F. (2013). Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation. Chronobiology International, 30(1-2), 280-314.

Kaplan, N. M. (2010). Kaplan’s clinical hypertension. Lippincott Williams & Wilkins.

Krause, T., Lovibond, K., Caulfield, M., McCormack, T., & Williams, B. (2011). Management of hypertension: Summary of NICE guidance. BMJ, 343, d4891.

Markandu, N. (2017, September 18). The role of nurses in treating and managing high blood pressure. Retrieved from https://www.nursingtimes.net/opinion/the-role-of-nurses-in-treating-and-managing-high-blood-pressure-18-09-2017/

Veerbeek, J. H., Hermes, W., Breimer, A. Y., Van Rijn, B. B., Koenen, S. V., Mol, B. W., … & Koster, M. P. (2015). Cardiovascular disease risk factors after early-onset pre-eclampsia, late-onset pre-eclampsia, and pregnancy-induced hypertension. Hypertension, 65(3), 600-606.

World Health Organization, n.d. Hypertension. Retrieved from: https://www.who.int/