Epidemiology Of Hypertension

Medical Surgical I
Disease Process of Hypertension
By
Ms. Margarita Minor, LPN

Pathophysiology The Merriam-Webster dictionary defines hypertension as an abnormally high arterial blood pressure that is indicated by an adult systolic blood pressure of 140mm Hg or greater or a diastolic blood pressure of 90mm Hg or greater. The cause is unknown but may be attributable to a preexisting condition that result in thickening and inelasticity of the arterial walls of the left ventricle and risk factors for various pathological conditions. It is often called the silent killer, because sometimes there are no symptoms, it is serious condition that lasts a lifetime. Hypertension can be controlled or prevented when
the right actions are taken and develop a healthy lifestyle. Hypertension can lead to heart disease, heart failure, kidney damage, stroke, heart attack, strained eyes or blindness and damage to the blood vessels. Blood pressure = Cardiac output * peripheral resistance, which is caused by an increase in cardiac output, total peripheral resistance. Conditions that increase heart rate or stroke volume will increase the cardiac output. Factors that that increase blood viscosity will increase peripheral resistance. Risk factors for hypertension may include family history, race, stress, obesity, diet high in fat or sodium, use of tobacco or oral contraceptives, sedentary life style and ageing, sleep apnea.
Signs and Symptoms During an assessment you may see elevated blood pressure, headache, vision disturbance, dizziness, left hypertrophy, papilledema, some uncomplicated hypertension may be asymptomatic even though progressive cardiovascular damage may be occurring. The signs and symptoms are not seen until vascular changes in the heart, brain or kidneys occur.

There are several diagnostic tests that will reveal predisposing factors and identify the cause of hypertension. ECG may show left ventricular hypertrophy or ischemia. A chest X-rat may show cardiomegaly. The funduscopic eye examination will reveal retinal changes such as retinopathy, papilledema, and vasoconstriction. Blood chemistry : elevated sodium, Bun, creatinine, and cholesterol levels, also high blood pressure is diagnose by sustained blood pressure readings greater than 140/90 mm Hg, urinalysis that show protein, red blood cells or shite blood cells that suggest renal disease.
Treatment
Treatment begins with life style modifications such as exercise, losing weight, a diet high in fruit, vegetables and grains, and low in sodium, fat and cholesterol, reduce alcohol intake, avoid tobacco and find ways to reduce stress.
The doctor may recommend medication to lower your blood pressure; there are several medications that are used to control high blood pressure. 1.) Diuretics, it acts on the kidneys to help your body eliminate sodium and water, reducing blood volume. 2.)Beta-blockers reduce the workload of the heart and open the blood vessels. 3.) Angiotensin-converting enzyme inhibitors help to relax blood vessel and the Angiotensin II receptor blockers also help relax blood vessels. 4.) Calcium channel blockers that help relax the muscles or your blood vessels, slow heart rate. Some additional medications that are sometimes used to treat high blood pressure include: alpha-blockers, alpha-beta blockers, central-acting agents, vasodilators and aldosterone antagonists. The goal of the treatment for healthy adults age 60 or alder is to have a blood pressure less than 150/90 and younger adults less than 140/90 and also if you have chronic kidney disease, diabetes or coronary artery disease.
Nursing Interventions Nursing Interventions for Hypertension: includes maintain patient’s diet, assessing cardiovascular status, encourage patient to express feelings, maintain quiet environment, administer medications Educate patient about smoking cessation, stress reduction, action, adverse effects of medication, risk factors modification, there are no surgical interventions for
hypertension.