Hypertension
Epidemiology process
Hypertension is an epidemic that has affected many people across the world with an estimated 25 percent of people believed to be suffering from the disease. It has been affirmed that the epidemic is not limited to only rich people but affect population across all age groups across the world. Statistics have also pointed out that hypertension is responsible for 51 percent of cerebrovascular disease and 45 percent of ischemic heart disease deaths. This paper will therefore investigate on the epidemic and provide an epidemiology understanding of hypertension that will be significant in reducing the burden that is often associated with morbidity and mortality across the world.
Medical experts have confirmed that hypertension condition arises when blood pressure is abnormally high and has been blamed on smaller blood vessels narrowing that prompt blood to exert excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure (Kear, 2015). Medical specialists have opined that pathogenesis process of hypertension is also attributed to humoral mediators, vascular reactivity, circulating blood volume, vascular caliber, blood viscosity, cardiac output, blood vessel elasticity and neural stimulation (Kear, 2015).
Hypertension in Individuals of Ages 45-65 and Above 65
Medical experts have confirmed that hypertension is common among the older population that is, adult of the middle age of between 45 and 65 and older adults of above 65 years (Potts, 2014). The high cases of hypertension among the older individuals are primarily due to wear and tear of the aorta that causes stiffness to large arteries making the heart to pump blood harder (Potts, 2014). The other reason is the increased systolic blood pressure that causes fluctuations in blood pressure (Potts, 2014). However, it is evident that hypertension healthcare outcomes for those between 45 and 65 years is much more improved than the older individuals, this is because they are better placed to access healthcare services. Data evidence has established that there is an increase in cardiovascular morbidity with increasing systolic or diastolic pressure in those aged 65 and over. Moreover, statistics have confirmed that this morbidity is at least double that seen in individuals aged 45 and 65.
Risk factors
Evidence has pointed out that hypertension is associated with many risk factors that comprise age where the risk increases with increase in age of an individual (Kear, 2015). Studies have confirmed that through early middle age, high blood pressure is more common in men with women likely to develop the problem after age 65. Race has also been found to be a risk factor for the disease with specialists attesting that it is common among blacks with serious complications such as stroke, heart attack and kidney failure being common (Kear, 2015). Third, some families have also been associated with hypertension, in this case, hypertension tends to run in families and so future generations of such families are likely to develop the problem.
Overweight has always led to the problem this is because medical professionals have affirmed that the more an individual weigh the more blood needed to supply oxygen and nutrients to other body tissues, when blood is circulated a lot of pressure is exerted on the artery walls (Kear, 2015). Other risk factors associated with the problem include lack of physical exercise, excessive consumption of tobacco and alcohol, using too much salt that in the process retains body fluids, insufficient potassium and vitamin D in the diet, high levels of stress and presence of certain chronic conditions in the body.
Care Plans and Goals
Nursing care plan goals will be to establish and investigate blood hemoglobin, blood urea nitrogen, glucose, serum potassium, serum calcium, lipid panel, thyroid studies, urine aldosterone level, urinalysis, creatinine clearance, uric acid and kidney renography nuclear scan. Nursing plans will have goals that may be achieved at the end and includes maintaining and enhancing cardiovascular functioning, preventing complications associated with hypertension, providing sufficient information about disease and supporting active patient control.
Measurement for the Goals
In order to ensure that the goals for patient centered care plans are achieved there have to measures to confirm and include blood pressure measurement if within acceptable limits for the patient. Evidence of minimized cardiovascular and systemic complications, increased understanding of the disease process, changes in behavior and lifestyle conditions of the patient and adequate plans to meet the need after discharging the patient are also measurements.
Current Standard of Care
The current standard of care states that individuals with mild hypertension can begin treatment with therapy consisting of change in diet, implemented exercise and other lifestyle modifications (Lambie, 2014). It is asserted that hypertension remains one of the most common causes of congestive heart failure and that the therapy is instrumental in reducing the risk of death from stroke and coronary artery disease (Lambie, 2014). Other studies have also confirmed that a reduction in blood pressure may improve renal functioning of an individual and so early detection of the medical issue may prevent progression and complication of the issue (Lambie, 2014). Standard care entails identifying prehypertension that requires lifestyle modification to prevent progression, issuance of drugs for uncomplicated hypertension and regardless of the therapy care it is believed that hypertension may be controlled only if patients are motivated to stay on their treatment plan.
Current Practice
According to available data, United States has shown an improvement in the number of hypertension patients detected though, there is still an under performance in terms of the number of patients who are receiving treatment. The reasons for the underperformance are due to the asymptomatic nature of hypertension that can lead to problems over incompatibility with treatment (Lambie, 2014). It is also clear that physicians may not be aware or confident of the recommendations and aims of more aggressive antihypertensive treatment. It is also important to note that certain issues arise as to whether physicians believe that it is possible to treat hypertension effectively (Lambie, 2014). This current practice is supported by the evidence based research that shows that in a community based population it is possible to hit blood pressure targets. Studies have also indicated that different patients receive different number of drugs due to incompatibility nature of the problem with some patients receiving two drugs, other three to control their blood pressure. It is worth pointing out that higher blood pressure control has a positive, rather than a negative, influence on quality of life of an individual (Lambie, 2014).
Team Members
Research has discovered that hypertension team includes a primary care physician whose responsibility to conduct diagnostic examinations, a nurse to conduct education and counseling services and a hypertension specialist whose responsibility is to evaluate patients who have high blood pressure (Lambie, 2014). In addition, the team also comprises of a pharmacist to administer medication, a nutritionist to help in educating the patients on how they can transform their lifestyles, community health workers to assist with self-monitoring and a records manager to keep accurate information about patients.
Strategies to Modify Behavior and Lifestyle
Behavior and lifestyle modification is essential in the prevention of hypertension; therefore, appropriate strategies are needed to effectively help the patients. The strategies would be to offer counseling education, organize workshops and training on wellness and taking leadership roles in promoting healthy living. The strategies would be helpful in imparting knowledge oh how to lose weight, quitting smoking, limiting alcohol consumption and performing regular exercise. The other strategy would be surgical intervention where Aorta-renal bypass is conducted using a saphenous vein graft (Potts, 2014).
Implications
The outcomes reported have been useful for both nursing practice and research; data collected from patient centered research have strengthened evidence based practice, patient education programs and increased efficiencies in the medical healthcare system. It has been established that through this initiative patient will be more informed and would be engaged in different health choices and make sound health decisions. It is asserted that nurses will also be well positioned to make decisions and recommendations to other healthcare stakeholders (Potts, 2014). Patient centered research is instrumental in future research, it has implicated the role of nurses in providing care to patients and thus future research should highlight robust economic assessment of patients.
Conclusion
The study has highlighted the risk factors associated with hypertension and suggested ways and strategies that can help prevent or minimize the occurrences of the problem. The study has affirmed the roles played by nurses in prevention of hypertension and the implications of patient centered research on nursing practice and future research. However, there is need to reinforce strategies on plans for prevention of hypertension to members of community.
References
Kear, T. (2015). Placing patients with hypertension at the center of self-management
research. Nephrology Nursing Journal, 42(2), 181-185, 189.
Lambie, J. (2014). Home blood pressure monitoring in hypertension. British Journal of Cardiac
Nursing, 9(1).
Potts, K. (2014). Hypertension in older people: assessment and management. Clinic Review, 16(3).