...Hypertension Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Hypertension is the consistent elevation of systemic arterial blood pressure. It is also the most common primary diagnosis in the United States (Brashers, 2010). It is one of the most common worldwide diseases afflicting humans. Because of the associated morbidity and mortality and the cost to society, hypertension is an important public health challenge. Over the past several decades, extensive research, widespread patient education, and a concerted effort on the part of health care professionals have led to decreased mortality and morbidity rates from the multiple organ damage arising from years of untreated hypertension. I. Prevalence of disease (in US) and risk factors Hypertension is a major U.S. health problem affecting some 50 million individuals. Approximately 65% of Americans older than age 60 have hypertension. Of those diagnosed with hypertension, over 30% do not have their hypertension adequately treated and controlled. Ninety to ninety-five percent of hypertension is idiopathic and called primary hypertension. Five to ten percent of hypertension is the result of an identifiable etiologic cause and is called secondary hypertension. According to Center of Disease Control (CDC) the prevalence of hypertension, 45.3% had been treated...
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...According to Brown & Edwards (2012) hypertension is defined as persistent systolic blood pressure greater than or equal to 140mmHg and a diastolic reading greater than or equal to 90mmHg on 2 consecutive clinician visits. Thus resulting in the heart and the vessels being put under great strain. There are two classifications of hypertension these being: Primary Hypertension, which is an increased blood pressure with an unidentified cause, it accounts for 90-95% of all cases of hypertension (Brown & Edwards, 2012). The second is secondary hypertension, which is an increase in blood pressure with a known cause and can be identified and corrected. Secondary hypertension accounts for 5-10% of hypertension in adults and 80% in children (Brown & Edwards, 2012) Patients who suffer hypertension have an increased peripheral resistance accounting for the high pressure, whilst cardiac output remains normal, while arteries and arterioles remain limited to maintain that constant flow of blood. Peripheral resistance is the resistance to blood flow determined by the tone of vascular musculature and diameter of the blood vessels (Crisp & Taylor, 2009). Peripheral resistance is blood circulating through arteries, arterioles, capillaries, venules and veins. Arteries and arterioles are surrounded by smooth muscle, which contracts and relaxes to change the size of the lumen, the smaller the lumen the greater the peripheral resistance to blood flow. As the pressure rises the arterial blood pressure...
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...Hypertension John Smith, age 63 was recently diagnosed with hypertension. His family will be accompanying him today to speak with me about his treatment options. To prepare for my discussion with Mr. Smith and his family, I want to gather some simplistic information about hypertension. Hypertension is an abnormal rise in blood pressure. Blood pressure is the blood that is pumped into and out of the heart. The systolic pressure, also known as the blood leaving the heart, is what occurs when the heart contracts (or squeezes). The diastolic pressure is found in the arteries when the heart is resting. Your physician typically displays your blood pressure results as 130/70 or systolic/diastolic. Hypertension involves major parts of the body, like your heart, kidneys, and the brain. Each plays an essential part of the body function like blood pressure. When hypertension occurs, it puts stress on these parts of your body. It can cause coronary heart disease that leads to heart attacks, strokes, kidney failure, and even premature death. Things like cigarette smoking, eating fatty foods, little to no physical activity and even consuming too much salt and sodium can cause a rise in blood pressure leading to hypertension. Hypertension is not the result of one or two blood pressure test coming back elevated. It is the result of several repeated blood pressure test over a span of time coming back in an above normal range. Normal ranges under 120/80 are typically where your physician would...
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...Hypertension Hypertension is high blood pressure. Blood pressure is the force of blood pushing against the walls of arteries as it flows through them. Description As blood flows through arteries it pushes against the inside of the artery walls. The more pressure the blood exerts on the artery walls, the higher the blood pressure will be. The size of small arteries also affects the blood pressure. When the muscular walls of arteries are relaxed, or dilated, the pressure of the blood flowing through them is lower than when the artery walls narrow, or constrict. Blood pressure is highest when the heart beats to pump blood out into the arteries. Between beats, when the heart relaxes to refill with blood, the pressure drops to its lowest point. The blood pressure peak, when the heart pumps, is called systolic pressure. The blood pressure trough, when the heart is filling, is called diastolic pressure. When blood pressure is measured, the systolic pressure is stated first and the diastolic pressure second. Blood pressure is measured in millimeters of mercury (mm Hg). For example, if a person's systolic pressure is 120 and diastolic pressure is 80, it is written as 120/80 mm Hg. The American Heart Association considers systolic blood pressure less than 140 and diastolic blood pressure less than 90 normal for adults. Hypertension is a significant public health problem. Since it has no symptoms, many people are unaware that they have hypertension. In the United States...
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...2/2/2016 6 Ways to Prevent Hypertension - Hypertension Center - Everyday Health Recommended For You Are You Eating Too Much Salt? Are Your Meds Raising Your Blood Pressure? Brought to you by Everyday Health 6 Ways to Prevent Hypertension By Krisha McCoy, MS | Medically reviewed by Pat F. Bass III, MD, MPH Making an effort to prevent high blood pressure can reduce your risk of heart attack, stroke, and other serious illnesses. If you are at risk for hypertension, take these steps to help prevent it. High blood pressure, which is also called hypertension, increases your risk of developing many serious health problems, including heart disease, stroke, and kidney disease. It is estimated that nearly one out of every three Americans has high blood pressure. While you can't always control whether you get high blood pressure, there are healthy lifestyle habits you can develop to help prevent hypertension and reduce your risk of high blood pressure-related health problems in the future Hypertension Prevention Factors You Can Control Your age, along with a family history of hypertension and ethnicity are among the hypertension risk factors that are out of your control. When it comes to preventing high blood pressure, the idea is to focus on the risk factors that you can change. "We can't do anything about our age, but we can do something about our lifestyle," says Gbenga Ogedegbe, MD, MPH, a clinical hypertension specialist, director of the Center...
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...Hypertension John Smith, age 63 was recently diagnosed with hypertension. His family will be accompanying him today to speak with me about his treatment options. To prepare for my discussion with Mr. Smith and his family, I want to gather some simplistic information about hypertension. Hypertension is an abnormal rise in blood pressure. Blood pressure is the blood that is pumped into and out of the heart. The systolic pressure, also known as the blood leaving the heart, is what occurs when the heart contracts (or squeezes). The diastolic pressure is found in the arteries when the heart is resting. Your physician typically displays your blood pressure results as 130/70 or systolic/diastolic. Hypertension involves major parts of the body, like your heart, kidneys, and the brain. Each plays an essential part of the body function like blood pressure. When hypertension occurs, it puts stress on these parts of your body. It can cause coronary heart disease that leads to heart attacks, strokes, kidney failure, and even premature death. Things like cigarette smoking, eating fatty foods, little to no physical activity and even consuming too much salt and sodium can cause a rise in blood pressure leading to hypertension. Hypertension is not the result of one or two blood pressure test coming back elevated. It is the result of several repeated blood pressure test over a span of time coming back in an above normal range. Normal ranges under 120/80 are typically where your physician...
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...Hypertension is a major risk factor for cardiovascular diseases and stroke which have a systolic and a diastolic blood pressure level of >140/90 mmHg. 31% of US adults continue to suffer from hypertension, with minorities being more likely to have the condition. Of these, 25% have uncontrolled blood pressure. Data from the National Health and Nutrition Examination Survey (NHANES) for 1999–2002 showed that the hypertension prevalence rate was highest among African American, almost 50% higher than white people. African Americans develop hypertension at an early age, reach advanced levels of hypertension, are prone to experience further complications, and are less likely to attain control of their hypertension. Hypertension is a leading cause of preventable death in the United States and among African Americans. African Americans have the highest risk for hypertension-related deaths. Among all racial/ethnic groups, African American women have the highest prevalence (45%) and lowest control of high blood pressure (59%). NHANES data examining the 2001–2010 time period also showed African Americans were more likely to have uncontrolled hypertension than white people and Hispanic people. Poor adherence to medication has been identified as a major contributor to uncontrolled hypertension among African American patients. Women are about as likely as men to develop high blood pressure during their lifetimes. However, for people younger than 45 years old, the condition affects more men...
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...Hypertension is word that is used to describe high blood pressure .Blood pressure is the force the blood produces against the arterial wall as your heart pumps. The heart pumps the blood though the artery as it flows it pushes the blood against the walls of the arteries creating pressure. The higher the pressure is against the wall the higher the blood pressure will be. The pressure is related to the size of the artery which the blood passes through the smaller the artery is the higher the pressure will be. The pressure is measured in milliliters of mercury Blood pressure is at the highest when the heart contracts or pumps the blood through the arteries this measurement is called the Systolic pressure. The blood pressure is at the lowest when the heart is at rest or filling up with blood this measurement is called the Diastolic pressure. Blood pressure is measured by two numbers which is the Systolic number or the top number and the Diastolic number or the bottom number. For example the pressure is usually written as 120/90 mm Hg. According to the American Heart Association defines hypertension as any of the following “Having an untreated systolic blood pressure of 140 mm Hg or higher. Having a diastolic blood pressure of 90 mm Hg or higher .Taking antihypertensive, being told at least twice by a physician or other healthcare professional that you have hypertension" ( The American Heart Association 2011). Hypertension is referred to as the silent killer as there are little symptoms...
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...Renal hypertension is an elevated blood pressure caused by kidney disease. It is caused by a narrowing in the artery that delivers blood to the kidney. Renal hypertension usually causes no symptoms. The narrowing in the arteries can't be felt. Unless it's dangerously high, high blood pressure causes no symptoms either. Symptoms of severely elevated blood pressure include: • Headache • Confusion • Blurry or double vision • Bloody (pink-colored) urine • Nosebleed The vast majority of people with renal hypertension never experience these (or any) symptoms. High blood pressure is dangerous partly because there are no symptoms, so organ damage can occur slowly without being recognized.Renal hypertension can cause chronic kidney disease. This is a slow decline in kidney function. Until the condition is well advanced, chronic kidney disease also causes no symptoms.Because there are usually no symptoms, a doctor may suspect renal hypertension when someone has uncontrolled high blood pressure despite multiple medications or has unexplained chronic kidney disease. With Renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day cannot adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys can often help. Possible procedures include the following: Angioplasty, Stenting...
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...Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevatedHypertension is a common disorder and a leading cause of morbidity and mortality worldwide. The majority (90%) of patients have ‘primary’ or ‘essential’ hypertension where no identifiable underlying cause is found. The remaining minority (up to 10%) have ‘secondary’ hypertension where a cause is identified. Complete assessment of the hypertensive patient must include an assessment of overall cardiovascular risk and the identification of potential secondary causes of hypertension. Any decision to treat hypertension should be based on repeated blood pressure readings or the 24 h ambulatory BP measurements monitor. Treatment of hypertension is based on large international trials and extensive meta-analyses, which have now been condensed into established published guidelines. NICE/BHS proposes the ACD rule that recommends drug classes that can be used to control blood pressure depending on the age and race of the patient.Most patients will require two or more drugs and will need to be followed up for side effects and nonadherence. It is important to be vigilant for secondary causes of resistant hypertension. Epidemiology The prevalence of hypertension in the general population is about 20e30% and more frequent with increasing age and in certain ethnic groups. Isolated diastolic or systo-diastolic hypertension is more...
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...Pathophysiology Blood normally flows silently through the heart, however there are conditions that can create a turbulent blood flow. Conditions that contribute to turbulent blow flow include increased blood velocity, structural valve defect, valve malfunctions, and abnormal chamber opening (Potter, Perry, Hall, & Stockert, 2013). Hypertension is a condition that can cause increased blood flow throughout the heart is. Hypertension is associated with thickening and loss of elasticity in the arterial wall causing the heart to continually pumps against greater resistance((Potter, Perry, Hall, & Stockert, 2013). The classification for adults to be considered hypertensive is to have a systolic reading 140 or greater and a diastolic reading 90 or greater. Modifiable risk factors that contribute to hypertension are obesity, cigarette smoking, heavy alcohol consumption, high sodium intake, sedentary lifestyles, and continued exposure to stress. Incidences of hypertension are greater in patients with diabetes, older adults, and African Americans and contributing factors for heart attacks ((Potter, Perry, Hall, & Stockert, 2013). Mitral value prolapse could be another indicator of a heart murmur. The mitral value is located between the left atrium and left ventricle. . Mitral valve prolapse occurs when the two leaves of the mitral valve...
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...Hypertension- the consistent elevation of arterial blood pressure. Chronic HTN is a sustained systolic blood pressure of greater than 140 mmHg or diastolic pressure of greater than 90-99 mmHg after multiple measurements are made over several clinical visits. Basic Patho Disease of the vascular regulatory system in which the mechanisms that usually control arterial pressure within a certain (normal) range are altered. Medications 1. chlorothiazide (Diuril)- Acts on distal tubule and thick ascending limb of the loop of Henle by increasing excretion of water, sodium, chloride, potassium, magnesium. Common Side Effects- headache, dizziness, fatigue, orthostatic hypotension, hypokalemia, N/V, anorexia, constipation, urinary frequency, photosensitivity. Nursing Considerations- BP lying, standing; postural hypotension may occur, especially in geriatric pts. Electrolytes: sodium, potassium, chloride, calcium, magnesium; include BUN, blood glucose, CBC, serum creatinine, blood pH, ABGs, uric acid; glucose in urine if patient is diabetic. 2. hydrochlorothiazide (Microzide)- Acts on distal tubule and ascending limb of loop of Henle by increasing excretion of water, sodium, chloride, potassium. Common Side Effects- dizziness, fatigue, weakness, orthostatic hypotension, hypokalemia, N/V, anorexia, urinary frequency, hyperglycemia, hyperuricemia. Nursing Considerations- BP lying, standing; postural hypotension may occur, especially in geriatric pts. Signs of metabolic...
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...Hypertension or High blood pressure is a prevalent cardiovascular disease in the United States and other nations around the world. It is estimated that 1 billion is affected with the disease and about 7.1 million hypertension related mortalities annually. It is a condition in which the long-term force of blood against artery walls is high enough to ultimately cause heart attack, aneurysm, stroke or left ventricular hypertrophy leading to congestive heart failure. Many people with hypertension do not realize they have because the symptoms are subtle and that it generally develops over a long period of time. Most often, vital organs like the kidneys and eyes may damage or other diseases may occur before it is detected; for this reason, it is often called the "silent killer (American Heart Association, 2014). According to Woo & Wynne (2012), a report from the World Health Organization indicates that suboptimal blood pressure higher than 115mm Hg (systolic) is liable for 62% of all cardiovascular disease and 49% of all ischemic heart disease. A normal blood pressure level is systolic reading of blood pressure (SBP) less than 120mmHg with diastolic level (DBP) less than 80mmHg. Hypertension disease has the following stages. A pre-hypertensive level is SBP 120-139, and DBP 80-89. Hypertension stage 1 is SBP 140-159, with DBP of 90-99. Hypertension stage 2 is SBP greater than or equal to 160 with DBP of 100 or more. Stress and emotional tension may temporarily increase blood pressure;...
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...Care Plan Elements of Hypertension Susan Salby American Sentinel University Care Plan Elements of Hypertension Worldwide, hypertension is the most common contributor to death of any medical risk factor. HTN contributes to the development of heart disease, heart failure, chronic renal failure requiring dialysis, stroke, peripheral vascular disease and cognitive decline. The risk of cardiovascular events doubles for every 20/10mmHg rise in blood pressure above 115/70mmHg. Untreated HTN causes progressive renal and vascular damage, eventually leading to a treatment resistant state. Hypertension is usually diagnosed and treated in the community. As this is largely an asymptomatic disease, particularly in its initial stages, compliance with treatment regimens can be problematic. Successful treatment of HTN relies on the patient establishing an ongoing therapeutic relationship with a trusted and knowledgeable health professional (Casey, 2011). Tools to manage care, such as clinical pathways, practice guidelines, and best practices have increased as the health care insurance industry has put more pressure on health care providers to improve care and provide more cost-effective care. These tools offer health care providers the opportunity to determine the best approaches to clinical problems based on current research and expertise (Finkleman, 2011). Best Practices Best practices are those treatments, procedures, tests, therapies and interventions that have consistently...
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...Hypertension and the Renin-Angiotensin-Aldosterone System Renin-Angiotensin-Aldosterone System The renin-angiotensin-aldosterone system, otherwise known as RAAS is a complex hormone system that regulates blood pressure and fluid balance in the human body. When blood volume is low, juxtaglomerular cells in the kidneys activate prorenin, which secretes renin directly into the blood stream circulation. Subsequently, a drop in blood volume additionally releases angiotensinogen from liver, in which renin converts into angiotensin I. Angiotensin I is then converted to angiotensin II through the enzyme angiotensin converting enzyme (ACE) found in the lung. Angiotensin II is a potent biological compound that causes blood vessels to constrict, resulting in an increase in blood pressure. Additionally, angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Furthermore, thirst or antidiuretic hormone can effectively stimulates the pituitary gland, which could release corticotropin-releasing hormone stimulating the adrenal cortex and thereby releasing aldosterone. Aldosterone contributes to the RAAS system by causing the tubules of the kidneys to increase the reabsorption of sodium and water back into the blood stream. Thus, an increase in the reabsorption of water, increases the volume of fluid in the body, which increases the blood pressure. Once the blood volume and blood pressure stabilizes, these collective effects triggers a negative feedback...
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