Hypertension, also commonly referred to as high blood pressure, is one of the most ubiquitous yet nettlesome medical problems affecting millions of people around the world. Hypertension is one of the major risk factors for coronary heart disease, hemorrhagic stroke, ischemic myocardial infarction, cerebrovascular accidents, chronic renal failure and congestive heart failure among people living in industrialized countries(Mohler & Townsend, 2006). Blood pressure is considered to be normal if it measures 120/80 orlower. In this example,120 represent the systolic blood pressure whereas 80 represent the diastolic blood pressure. However, if either systolic or diastolic blood pressure rises above 140 and 90respectively, then there is a high likelihood of one to develop hypertension. According to the National Heart, Lung and Blood Institute (NHLBI), one in three people have hypertension (Black & Elliot, 2007). Furthermore, demographic studies have confirmed that approximately 7.5% of the adult populations worldwide have already succumbedtohypertension (Mohler & Townsend, 2006). According to the World Health Organization, the prevalence of elevated blood pressure in adults aged 25 and above was around 40% in the year 2008 (Whitworth & Chalmers, 2003).Research studies indicate the African continent to have the highest level of hypertension prevalence with over 46% of the population being at risk from developing high blood pressure. On the other hand, America has the lowest prevalence rates of people suffering from high blood pressure with an approximately 35% of the population suffering from hypertension. In both America and Europe, men are described to be at a higher risk of developing high blood pressure as compared to women. The World Health Report that was released by the World Health Organization in the year 2002 further revealed ischemic heart disease and cerebrovascular stroke to be the leading cause of mortality worldwide (Whitworth & Chalmers, 2003).
The disease is described as being asymptomatic while a few symptoms may showcase themselves as a result of lifestyle modifications and medications. In addition to this, most of the individuals suffering from hypertension discover their diagnosis only after they have developeda cerebrovascular stroke or myocardial infarction. Even though the disease may be treated, prolonged elevated blood pressure can lead to severe consequences such as death. Some of the leading risk factors include family history, stress, obesity, tobacco use, sedentary lifestyle and aging.High blood pressure, has also been dubbed as an ‘illness for the civilized’ due to its causative factors being poor diet, lack of physical exercise and stress (Black & Elliot, 2007). Approximately 26% of the worldwide adult population is currently suffering from high blood pressure and the number is expected to further increase during the years to come.Epidemiological studies reveal that 20% –60% of the population suffering from hypertension disease is as a result of the person having genetically inherited the disease from their birth parents (Whitworth & Chalmers, 2003).
Hypertension disease is categorized into two major forms depending on the cause of the development and progression of an elevated blood pressure. Thus, hypertension is classified as either being primary/essential hypertension orsecondary hypertension. There is no clear known cause for essential hypertension whereas there is always an obvious clear cause for a person developing the secondary form of hypertension (Black & Elliot, 2007). Some of the well-defined causes of secondary hypertension include; Diabetic Nephropathy, Rennin Producing Tumors, Hydronephrosis, Polycystic Kidneys, Hypothyroidism, Hyperthyroidism, acute Stress, Arteriosclerosis and Carcinoid (Black & Elliot, 2007). In other cases, patients may have developed hypertension disease as a result of having a raised peripheral resistance with a normal cardiac output(Black & Elliot, 2007). Peripheral resistance is said to be determined by small arterioles whose walls contain smooth muscles that contract as a result of high levels of intracellular calcium concentration, eventually resulting in high blood pressure (Whitworth & Chalmers, 2003).Eventually, severe cases of hypertension may cause gross damage to the body organs such as the heart, kidneys, retina, aorta, arteries or the central nervous system.
Thevast majority of people suffering from hypertension are put ona certain medicationso as to maintaintheir blood pressure ata normal level. In certain cases, these patients may experience side effects that arise as a result of taking the medication. In the worst cases, the prescribed medication may be ineffective to the patient who would constantly record a high blood pressure. Depending on age, the elderly may be described certain specific drugs such as an ACE inhibitor or an angiotensin-2 receptor blocker (Black & Elliot, 2007). On the other hand, patients below the age of 55 are usually prescribed different types of medication known as calcium channel blockers. Some of the calcium channel blockers include verapamil, diltiazem, felopidine and nifepidine. The common side effects of this type of drug may be headaches, swollen ankles and constipation (Mohler & Townsend, 2006).
One of the effective ways forone tocontrol their own level of blood pressure is by adjusting to a healthier lifestyle. This may be by performing regular exercises, feeding on a nutritious diet and by avoiding taking too much salt and sugar. The affected person should also halt some of the risky behaviors such as smoking, feeding on too much fat and also drinking too much alcohol (Whitworth & Chalmers, 2003).
Cultural Sensitive Care
In order to promote an improved condition to hypertension patients, it is vital for nurses to have a full comprehension of their patients’ cultures. Knowing the patient’s culture would assist the medical providers tointegrate culture as part and parcel of an effective medical treatment for hypertension (Mohler & Townsend, 2006). The medical practitioners should consider each patient as having unique health and disease practices and beliefs as this would help them to tailor effective treatment plans that suit and meet the needs of the patient. In United States, a vast majority of the African American citizens are known to develop high blood pressure as compared to other ethnicities that reside in America. In fact, one out of every three African-Americans tends to develop hypertension even before they attain adulthood. In fact, the majority of African-Americans with low socioeconomic backgrounds are more often than not exposed to certain common practices and risky behaviors such as smoking, drinking of alcohol, drug abuse, feeding on high cholesterol meals and in other cases they may develop chronic illnesses such as diabetes and obesity, which all eventually contribute to the individual developing high blood pressure (Mohler & Townsend, 2006). Thus, it is vital for the health care providers to understand the culture and beliefs of their patients so as to better assess whether the patient would adhereto a certain medication plan or lifestyle changes or not. This would be essential as the medical practitioner would be able to develop suitable treatment and medication plans for the African-American citizen suffering from hypertension.
This is an example of a NANDA nursing diagnosis on hypertension.
A 45 year-old woman visits the clinic and complains of constant migraines and blurred vision. In order to check on the patient’s health status, hertemperature and blood pressure had to be measured. Her temperature was 37 º Celsius but her blood pressure was 220/110. She also had diabetes and weighed 95 kg thereby indicating that she was obese.
Nursing diagnosis 1
Decreased cardiac output was as a result of myocardial ischemia, ventricular hypertrophy and vasoconstriction (Mohler & Townsend, 2006). A reduced cardiac output may also be associated with an increased peripheral vascular resistance secondary to hypertension as evidence by BP 220/110.
Nursing diagnosis 2
Patient complaining of blurred vision, and headache. The migraine or constant headache is as a result of an increased cerebral vascular pressure.
In conclusion, hypertension is a long-term medical condition that can be managed with proper treatment and medication as prescribed by doctors. High blood pressure may also develop due to an individual’s own lifestyle. Eating of food with high cholesterol, taking too much salt and sugar and poor physical fitness are some of the factors attributedto the development of hypertension. Therefore, it is an individual’s responsibility to safeguard their own health by adopting a healthy lifestyle. This requires one to be disciplined and adhere to a healthier diet whilst also doing regular physical exercise.
Whitworth, J. A., & Chalmers, J. (2003). World health organisation-international society of hypertension (WHO/ISH) hypertension guidelines. Clinical and experimental hypertension (New York, NY: 1993), 26(7-8), 747-752.
Black, H. R., & Elliott, W. J. (2007). Hypertension: A companion to Braunwald’s heart disease. Philadelphia, PA: Saunders Elsevier.
Mohler, E. R., & Townsend, R. R. (2006). Advanced therapy in hypertension and vascular disease. Hamilton, Ont: B.C. Decker.