Hypertension Prevention and Treatment

Hypertension is a medical condition that is commonly known as high blood pressure. The condition is diagnosed when the blood pressure of an individual is consistently elevated as determined by a number of various measurements of both diastolic and systolic blood pressure. The blood pressure is elevated in the arteries of the heart. Hypertension is a chronic medical condition that needs ongoing treatment to monitor and maintain the levels of blood pressure. The pathophysiologic process of the condition will be analyzed in order to understand the condition. The signs and symptoms of hypertension will also be discussed in order to improve early detection and treatment of the condition in patients that nurses may work with. Hypertension in pregnancy will then be explored to show how harmful the condition can be in a vulnerable population such as pregnant women. Through this comprehensive study of the condition it can be treated effectively.

Hypertension occurs when the blood flow is restricted in the arteries. This makes the heart work harder to ensure that blood flow is occurring in the heart. While the cardiac output is average in the individual, the restricted blood flow leads to increased blood pressure. Many factors can contribute to restricted blood flow in the arteries. One of these factors is the narrowing of the arteries, which can cause further restriction of blood flow. The capillaries also play a factor as the number of capillaries or their density can decrease leading to increased blood pressure. Multiple other factors can increase blood pressure most of which occurs within the heart.

Increased heart rate, venous return and cardiac preload can all increase chances of an individual becoming diagnosed with hypertension. The condition usually occurs in older individuals however younger individuals can begin to have signs of high blood pressure. The condition can be life threatening in the elderly however it can be maintained through the use of medication. Younger individuals can be diagnosed with hypertension if the sign of hypertension are evident through a screening. The diagnosis for this type of hypertension is referred to as pre-hypertension. Hypertension can be either primary or secondary depending on the cause of the condition. Primary hypertension refers to the common case of hypertension, which has been discussed earlier and is not caused by any other medical condition. Secondary hypertension is caused by other medical conditions. The most common cause of secondary hypertension is renal disease however the condition can occur as a side effect of a number of other debilitating medical conditions.

Without proper testing hypertension can be difficult to diagnose as individuals rarely present with signs or symptoms. Individuals rarely come into a medical doctor to complain of symptoms as a result of high blood pressure. Rather other factors influence them to come in for a medical screening. Some individuals may present with headaches, lightheadedness or period where they passed out however these symptoms are usually associated with another condition. Through a simple screening an individual’s blood pressure can be taken. Both a systolic and diastolic blood pressure is taken. If either of these numbers are on the high range then an individual can be diagnosed with high blood pressure. Individuals with average systolic numbers will have blood pressure between 90 and 119. Individuals with average diastolic blood pressure will have blood pressure between 60 and 79. Detection of high blood pressure is the key to preventing the diagnosis of chronic hypertension or to provide treatment and reduce the threat of the illness.

Hypertension can be caused by a number of environmental and genetic factors. Individuals with a family history of high blood pressure are more likely to be diagnosed with the condition. Environmental factors also have an impact on hypertension. Lifestyle choices such as a lack of exercise, unhealthy dietary choices and alcohol use can lead to high blood pressure. These lifestyle choices couples with high blood pressure can lead to other medical conditions such as diabetes. “Conversely, recent data suggest that hypertensive persons are more predisposed to the development of diabetes than are normotensive persons. Furthermore, up to 75% of CVD in diabetes may be attributable to hypertension, leading to recommendations for more aggressive treatment” (Sowers, 2001, p. 1053). Hypertension can also be caused by increased stress due to career difficulties or other life problems. While genetic factors cannot be prevented changes in lifestyle can improve the prognosis of an individual who may become diagnosed with the condition. Through nutritious eating, exercise and healthy lifestyle choices an individual can decrease their genetic risk by enhancing their environment. Individuals can also adopt relaxation methods to reduce their stress levels and also risk of hypertension. The classification of hypertension also refers to a number of other condition in various other populations such as pregnant women.

Hypertension in pregnant women is classified separately from other forms of high blood pressure. This is the case because the condition usually occurs as a result of being pregnant and not necessarily other environmental or genetic factors. However these factors can increase the likelihood of an occurrence of hypertension in pregnancy. “Mounting evidence clearly indicates an immunologic basis for PIH, parity being the most convincing factor. Genetic susceptibility, physiologic change, and environmental influence may also modulate an individual's risk of developing PIH” (Zhang, 1996, p. 218). Just as with hypertension genetic factors cannot be combatted however through controlling the environmental factors a pregnancy women can prevent the condition from occurring, which would improve her health outcomes as well as her baby.

Just as there are numerous forms of hypertension there are various types of hypertension in pregnancy. These various types of hypertension have varying diagnostic criteria to determine not only diagnosis but also treatment. “Many terms are currently used to classify the hypertensive disorders of pregnancy, and some systems of classification are quite complex and detailed. For example, the single entity designated here as preeclampsia has been called toxemia, gestosis, pregnancy induced hypertension and pregnancy associated hypertension by various authors” (Pipkin, 2000, p. 705). Preeclampsia is another condition that can occur as a result of hypertension. Preeclampsia can result in premature delivery and other associated risk factors to the baby and mother. Hypertension can also lead to eclampsia, which in extreme cases can result in seizures.

Hypertension in pregnancy is similar to regular hypertension as no distinguishable signs or symptoms occur during the condition. Through continuous monitoring of the mother’s blood pressure and the baby’s growth hypertension can be diagnosed if it occurs. Hypertension needs to be detected early in pregnancy as it can lead to other serious conditions that could affect the life of the baby and mother. “After stratifying by intrauterine growth restriction status, if infants were not intrauterine growth restricted, all types of PIH were not associated with increased perinatal mortality. However, when infants were intrauterine growth restricted, all types of PIH were associated with markedly increased perinatal mortality” (Xiong, 2007, p. 402).Women who have previously had hypertension, are obese or those who are pregnancy with more than one child are at increased risk of becoming diagnosed with hypertension. These women would need be monitored more closely than average pregnancies. While medication can be used to treat hypertension in individuals, pregnant women must be careful to ensure that the drugs do not affect the baby. Other treatment recommendations may include inducing labor in order to deliver the baby before the diagnosis of preeclampsia as it will begin to harm the life of the baby. Once the baby is delivered the symptoms of hypertension are no longer a concern for the mother if she maintains healthy lifestyle choices.

Hypertension is a serious condition as it can lead to heart attack, stroke and other diseases. Without treatment the condition can be fatal for individuals. Hypertension also has economic costs for our nation as the large amount of individuals with the condition put a strain on our health care system. With the busy and unhealthy lives that most individuals are living, the prevalence of hypertension is on the rise. This is especially in the case of young children. The condition was previously thought to only occur in older individuals. However as younger and younger individuals begin to be diagnosed with hypertension, research needs to be devoted to finding ways to prevent the condition from occurring.

While medication is the most common form of treatment of hypertension, lifestyle changes are more beneficial in treating and preventing the condition from occurring. However lifestyle changes are harder to implement than simply prescribing a patient medication that they must take. ‘The current challenge to healthcare providers, researchers, government officials, and the general public is developing and implementing effective clinical and public health strategies that lead to sustained dietary changes (such as with utilizing the DASH diet) among individuals and more broadly among whole populations” (Appel, 2006, p. 296). While these policy changes may be difficulty to implement, the impact of the changes can improve the health outcomes of many individuals who are risk of being diagnosed with hypertension and other related diseases. Through changing the unhealthy lifestyle choices of many individuals the negative health and economic impact of hypertension can be reversed.

References

Appel, L. J., Brands, M. W., Daniels, S. R., Karanja, N., Elmer, P. J., & Sacks, F. M. (2006).Dietary approaches to prevent and treat hypertension a scientific statement from the American Heart Association. Hypertension, 47(2), 296-308.

Pipkin, F. B., & Roberts, J. M. (2000). Hypertension in pregnancy. Journal of humanhypertension, 14(10-11), 705-724.

Sowers, J. R., Epstein, M., & Frohlich, E. D. (2001). Diabetes, hypertension, and cardiovascular diseasean update. Hypertension, 37(4), 1053-1059.

Xiong, X., Buekens, P., Pridjian, G., & Fraser, W. D. (2007). Pregnancy-induced hypertension andperinatal mortality. The Journal of reproductive medicine, 52(5), 402.

Zhang, J., Zeisler, J., Hatch, M. C., & Berkowitz, G. (1996). Epidemiology of pregnancy-induced hypertension. Epidemiologic reviews, 19(2), 218-232.