Hypertension and its Impact on the Health of Women - Essay Example

The Silent Killer Assessing, planning, implementing and evaluating a Health Promotion activity Hypertension and its impact on the health of women ages 16 to 30 Hypertension, a hidden and prevalent health risk in which blood pressure is appreciably elevated above normal, is a condition which, if left undetected and untreated, will put people in real peril of more serious health problems such as cardiovascular disease or kidney failure (Hart et al, 2000). In general, women tend to be less inclined to high blood pressure and tend to acquire it much later in life than men do (Horan, 2002). Yet statistics show that young adult women in the age group from 16 to 30 years that we target for our health promotion forum may have a certain broad susceptibility to hypertension that is specific to their youth and gender. Though explicit risks may occur during pregnancy and later in motherhood, many other unhealthy choices in numerous young adult lifestyles, such as excessive alcohol consumption, unwholesome cravings for fast food, routine motorized transit with scant exercise, and other risky behaviours come seriously into play (UK Department of Health, 2006). The majority of hypertensive individuals suffer from primary or essential hypertension which can be a many-sided enigma in that there are typically few if any warning signs and little definite evidence to indicate why the blood pressure is so elevated (Laverack, 2004). A tendency to higher than normal blood pressure can frequently be genetic and, for certain temperaments, persistent daily stress may heighten the problem further (Hart et al, 2000). To identify possible causes of hypertension takes complex detective work, though, as prevalent as it is in the wider population, higher-than-normal blood pressure itself is easily measured by screening for and monitoring it (Laverack, 2004). Predictably up to forty percent of adults in the UK suffer from hypertension, many unknowingly. The World Health Organization recognises high blood pressure world-wide as one of the major liabilities for premature death that is most easily tested for and treated (McNair, 2005). Detection of hypertension plays a leading role in the prevention of cardiovascular disease, which accounts for about a third of all deaths in the UK. Almost one out of four British women dies from heart failure (McNair, 2005). The epidemiological data suggests that hypertension within populations is directly related to mortality rates (UK Department of Health, 2006). High blood pressure is less a specific disease than a significant risk factor for other diseases and proves to be especially risky in that it so easily goes unnoticed and unmanaged (Stansfeld & Marmot, 2002). At the higher end of hypertensive problems across the population is the increased probability of unforeseen untimely death from stroke, heart disease, or kidney failure. At the lower end of the distribution curve is mild hypertension for which the risk of escalation and premature death can be lowered with responsible life choices for keeping a safe, healthy, normal blood pressure (Scala, 2002). Risk Factors for Hypertension One of the more common contributions to high blood pressure is the sedentary lifestyle prevalent in modern society. Exercise helps maintain normal blood pressure, but few of the young women in our contemporary world get the amount and quality needed to stay fit (Sullivan, 2005). Smoking is another source of hypertension. A cigarette lit habitually, while meant to relax, actually raises blood pressure as it forces the heart to work harder to sustain blood flow (Naidoo & Wills, 2005) . In addition, excess weight also forces the heart to pump harder, and when hypertension is diagnosed, getting rid of surplus pounds is a critical goal (Boaz, 2002). Along the same line a cholesterol-rich diet, excessive salt intake, and heavy alcohol consumption can all be factors contributing to a dangerous increase of blood pressure (Lucas & Lloyd, 2005). Ever-increasing Obesity Wide-reaching and growing obesity has lately become the developed world's greatest health challenge. Current reports indicate that the growing numbers for obesity may even surpass the data on heavy smokers in the mounting inventory of grave health dangers. Almost two-thirds of adults in the UK are obese, and 23 per cent of these are women that are about three stone overweight, which is a degree that sets their health at substantial risk. Alarmingly, figures for obesity have tripled in the past 20 years, and continue to climb steadily (UK Department of Health, 2006). Heavy Smoking Although many diseases caused by smoking, such as lung cancer and cardiovascular disease, are viewed as male illnesses, the more that female smoking grows prevalent, the higher the figures will be of women who die from what is a wholly-preventable health risk (McNair, 2005). If smoking is the largest cause of cancer deaths in the UK, it also increases a young woman's risk of heart disease as a corollary to hypertension. Females who smoke after taking birth control pills increase their risk of heart attack, stroke and peripheral vascular disease several times over (McNair, 2005). Especially in younger, people smoking is a major cause of coronary artery disease. The longer a person smokes, the greater their risk of heart attack. An entire pack of cigarettes a day also serves to double the risk of heart attack (McNair, 2005). The nicotine in a cigarette decreases oxygen to the heart, increases blood pressure and heart rate, causes blood clotting, and damages the cells that line the coronary arteries and blood vessels (Naidoo & Wills, 2005). If a packet of 20 cigarettes costs 5, at a packet a day an annual supply of cigarettes costs about 1,825. Over a lifetime of smoking, that means sending 73,000 up in smoke. A young woman will reap the greatest benefits for her health and budget by quitting early in life (McNair, 2005). Excessive Alcohol Consumption In the UK over one third of males and 23 percent of females between the ages of 16 and 24 habitually drink twice the advisable daily amounts. The figures of those that drink beyond a safe level is 45 percent for the number of young people in the16 to 24 age range, while it is only 10 percent for people over age 65. Of that young adult group nearly 42 percent are women compared to just 5 per cent in the senior category that are female (Drinking to Excess, 2004). Recent statistics show that far more young women ignore safe drinking limits in the UK today in contrast to figures collected barely five years ago. The Health Survey for England shows that 23 percent of women between 16 and 24 years of age drank over 21 units a week, while 14 units is considered to be the truly safe limit (Erens, 2003). Prenatal Concerns For young women, pregnancy-induced hypertension may surface in various ways. Blood pressure monitoring is an essential part of basic prenatal care. Hypertension may occur in up to 15 percent of pregnancies. A pregnant female might have one or more of four specific types of hypertension (Lucas & Lloyd, 2005). Chronic hypertension would be that of a women diagnosed with high blood pressure prior to pregnancy, and hypertension would typically develop before 20 weeks. Gestational hypertension commonly develops after 20 weeks with no associated loss of protein in the urine. Hypertension after 20 weeks gestation with loss of protein in the urine is diagnosed as pre-eclampsia, a condition in which a woman begins to show protein loss in addition to hypertension. The most common type is transient gestational hypertension which normally resolves after delivery. Gestational hypertension needs treatment when blood pressure remains high for more than 12 weeks after the infant's birth. Careful medical care prior to and during pregnancy is imperative. A women with chronic hypertension and on medication for the condition should consult with a doctor before getting pregnant (Lucas & Lloyd, 2005). Excessive Stress Though stress is noticeably linked to hypertension, it can be challenging to identify the cause of stress. Negative stressors for one person may actually be positive stimuli for another. Ascertaining sources of stress and levels of tension requires an extensive assessment of the interaction of specific personalities and lifestyles (Hart et al, 2000). Some of the more obvious stressors for young women in the target group revolve around the pressures of raising a family with concomitant financial worries, and frequently also in addition to having to juggle studies and a demanding job. For a single parent on her own the escalating responsibilities may be overwhelming and, in a inexorable downhill spiral, may severely impact her health and ability to cope. Social disadvantage and ethnic diversity contribute additional aspects of concern, since there seems to be a higher incidence of hypertension in UK citizens of African descent, as well as similar susceptibilities in the South Asian population in the UK (Cappuccio, 2007). The prevalence of high blood pressure in the developed world is high enough to justify hypertension being identified as a major public health objective for the UK Department of Health (2006). The recognition and management of hypertension comprise a key concern in the quality outcomes framework for general practitioners in England. In 2001 the National Health Service funded 90 million drug prescriptions for lowering blood pressure, representing nearly 15 percent of the entire annual expenditure for all primary care drugs at 840 million (Bunton & Macdonald 2002). Health Promotion Activity Apropos of the role of nurse practitioners Weare, in her article on "The contribution of education to health promotion," indicates that a vital aim of health promotion activity is empowerment, since it is not so much designed to steer people to a state of ideal health as to provide the compelling impetus to motivate someone to work to realise the level of health that person may choose to pursue. Only free choice and personal initiative will effectively implement a decisive agenda for genuine health and well-being. Education must aim at inspiring a young women to weigh her choices and decide independently to set attainable goals for the health she expects to arrive at (Bunton & Macdonald, 2002). However, the persistent demands of the realities of a young adult's life situation, a disadvantaged economic status, and hereditary susceptibilities may militate strongly against her best efforts to develop a healthy lifestyle. Weare points out that educating for healthy choices involves more than simply providing facts and naively assuming that reasonable decisions will inevitably follow. Most people with common sense have a fair idea of what may be healthy alternatives, but even highly-focused and motivated individuals get entangled in routines that seem from the outset to be futile to alter (Bunton & Macdonald, 2002). The young women in our Health Promotion activity have to be encouraged to become independent in their choices, become conscious of the sabotaging temptations that engulf them, and, above all, know where to get assistance in the daunting task of finding feasible and realistic ways to put their resolutions into practice (Lucas and Lloyd, 2005). Since awareness of a personal problem with hypertension is the first step to addressing the risk, the frst imperative is to teach young women how to screen accurately for high blood pressure. Normal blood pressure carries critical blood flow from the heart to all areas of the body, such as the muscles, internal organs, and brain. Blood pressure is gauged in two numbers: the higher is the systolic pressure which is the pressure the blood exerts against the walls of the blood vessels as the heart contracts. The lower is the diastolic pressure or the residual pressure between heart contractions as the heart relaxes (Yusuf, 2003). To show a young woman how to monitor her blood pressure and what the numbers represent provides a simple ongoing screen for the risk of cardiovascular disease and a periodic check for any escalation to a higher-than-normal blood pressure and the health hazard of severe and uncontrolled hypertension. The National Institute for Health and Clinical Excellence lists the guidelines for determining optimal, normal, and high-normal blood pressure as well as three increasing grades of hypertension (BHS Guidelines, 2006). For optimal blood pressure the systolic is less than 120 mmHg and the diastolic is less than 80. For normal the systolic is less than 130 mmHg and diastolic less than 85. High-normal for the systolic runs from 130 to 139 mmHg and for the diastolic from 85 to 89. In Grade 1 hypertension (mild) the systolic runs from 140 to 159 mmHg and the diastolic from 90 to 99. For Grade 2 hypertension (moderate) the systolic may be from 160 to 179 mmHg and the diastolic from 100 to 109. At the highest end of the spectrum is Grade 3 hypertension with the systolic pressure listed as equal to or greater than 180 and the diastolic pressure at equal to or greater than 110 (BHS Guidelines, 2006). Recommended Lifestyle Changes Scala (2002) recommends certain essential health-conscious alterations to any lifestyle in order to manage hypertension: first, to keep to what is considered the normal weight for adults, defined to be a body mass index of 20 to 25 kilograms for every 2 meters of height; second, to limit salt intake to 100 millimoles a day; third, to restrict consumption of alcohol to about 3 units a day for males and around 2 units a day for females; fourth, to take part in energetic aerobic exercise, preferably every day, no less than three days a week for at least 30 minutes; and, finally, to eat five or more portions of fresh vegetables and fruit daily, as well as lessen any intake of saturated and trans fats. A certain reciprocal relationship flourishes among each of these components of a heart-healthy lifestyle. Exercise and diet aid in losing weight while a loss of excess weight and healthy eating habits contribute to invigorating and energetic exercise. Weight Loss Diet is critical to weight loss and health. Unhealthy diets that are high in saturated and trans fats, highly processed sugars, and calories have a major effect on the growth in obesity. Low income restraints can affect food choices as well (Naidoo & Wills 2005). Young working mothers not only need to learn strategies for healthy food choices for themselves and their children but, above all, urgently need referrals to available resources. Indigent households have less than 25.50 a week to spend on food, in contrast to the 106 available to wealthier homes. Buying healthy food may take second place to other indispensable expenses such as rent, electric bills or gas (Tones & Tilford, 2001). If getting to major stores is restricted, low income families are left to purchase basic staples in neighbourhood shops at twice the cost. Healthier food can be higher priced and tougher to locate (Naidoo & Wills 2005). The basal metabolic rate of an individual is the measure of the calories the person needs to keep a normal temperature, a healthy blood flow, and even to breath or to think. Our basic metabolic rate is the energy we would burn if we "just lay in bed all day" (Scala 2002). If a woman is honest about her activity level, the basic metabolic rate for a sedentary female would be 1,677 calories; for a moderately active woman it would be about 1,806 calories. A very active young woman burns 2,064 calories, and an exceptionally active female athlete would burn about 2,322 calories (Scala 2002). Excess weight comes from consuming more calories than we burn, which in turn can depend on our natural metabolism. Since an overweight woman has a lower basal metabolism her excess fat acts as insulation as well, so she loses less heat to the environment and burns less stored fat. In a serious effort at weight loss a person must burn more calories than they consume and keep it up for a long enough time to tap into and burn the accumulated fat (Scala, 2002). The types and amount of food eaten per calories tallied, as well as the quantity and quality of daily physical exertion both come into play. Quite obviously, an awareness of calorie intake over time is as urgent for losing weight as the initiative of starting a more active and energetic lifestyle. An accepted preventive model of health promotion aims to persuade young women to make good food choices and count the dietary amounts consumed. However, research into the realities of British families from disadvantaged areas indicate that, though female heads of households know exactly what should make a healthy diet for themselves and their children, they actually are far more in need of concrete assistance from the local community for reasonable access to those nutritional options (Tones &Tilford, 2001). Aerobic Activity The report of the Chief Medical Officer At least five a week in 2004 highlighted a broad spectrum of considerable health benefits flowing from physical activity (Naidoo & Wills 2005). Reviews studying physical activity intervention programs found that approaches which had the greatest efficacy were characteristically home-based activities rater than more regimented plans, spontaneous exercise rather than supervised, though with regular professional support, and a focus on consciously revising routine daily options, such as walking wherever possible. Exceptional efforts were required in order to evaluate and find the healthier exercise settings desirable for socially disadvantaged groups (Naidoo & Wills, 2005). Exercise referral schemes within the national quality assurance framework for general practitioners were most successful where staff were trained in strategies for motivating behavior, with good practitioner-patient ratios for quality oversight, as well as when local communities were willing to take responsibility for and continue on after the initial intervention. Successful programs were generally those which enjoyed local interest and were specifically committed to dealing with obstacles to healthy exercise through long-term strategies (Naidoo & Wills, 2005). The Local Exercise Action Pilots (LEAP) evaluation by the UK Department of Health found that well-thought-out initiatives that were carefully supervised achieved considerable success both in success with appealing to target populations and in the positive implementation of the activity taking place. The most effective measures integrated the activity with the involvement of local settings and community action. The outreach initiatives fit activities to meet the interests of local participants and involved people in more than one option to help them stay actively engaged in the health promotion process (Barker, 2007). Conclusion The World Health Organization defines health promotion explicitly as a "unifying concept for those who recognize the need for change in ways and conditions of living, in order to promote health," (Tones and Tilford, 2001). Without a doubt both the aspect of "unifying," as well as the aspect of "recognizing the need for change," highlights the imperative of a broadly united community effort for a change in those "conditions of living" in public setting that empower and facilitate health options which should be open and accessible to the personal decision and initiative of each and everyone of its citizens. Bibliography Barker, Y. (2 April 2007) Learning from LEAP: a report on the Local Exercise Action Pilots. UK Department of Health. http://www.dh.gov.uk/en/Policyandguidance/Healthand socialcaretopics/Healthyliving/LocalExerciseActionPilotsLEAP/index.htm [6 April 2006] "BHS Guidelines for the management of hypertension." (28 June 2006). PowerPoint http://www.nice.org.uk/CG034NICEguideline [7 April 2006] Boaz, N. T. (2002). Evolving Health: The Origins of Illness and How the Modern World Is Making Us Sick. Chichester, West Sussex: John Wiley & Sons, Inc. Ltd. Bunton, R. & Macdonald, G. (eds) (2002). 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