Hypertension - Causes, Current Status, and Potential Interventions - Research Paper Example

Hypertension Affiliation Background information Hypertension is a cardiovascular disease that manifests through increased systolic and diastolic blood pressures as well as increased heart rate. In 2002, the World Health Organization (WHO) publicly declared hypertension as a number one killer disease making it a public health issue (Brady, 2012). Cardiovascular related diseases are responsible for about 17 million deaths annually almost a third of the annual global mortality. Of all the heart related diseases ,hypertension accounts for approximately 9.4 million deaths annually on a global scale (Ng, Stanley, & Williams, 2010). Hypertension is very rampant today affecting even young people when it was considered the disease for the old. It must be understood that it affects all gender, races, and economic levels equally. Hypertension accounts for 45% of deaths due to cardiovascular related diseases making it a more lethal killer than any other known heart disease thus being a significant public health problem (Myat, Redwood, Qureshi, Spertus, & Williams, 2012). Root causes of Hypertension The etiology of hypertension is very elaborate and complex since there are several factors falling into two interrelated classifications. There are uncontrolled factors that cause hypertensions, factors that an individual has no capacity to change whichever way he or she tries. Different from uncontrolled factors are those that individuals can influence, manipulate and control. These are factors within the environment and in most cases; people significantly determine how they interact with them. Uncontrolled Factors Heredity- this is the likelihood of certain families to have a gene responsible for hypertension. This trait is passed on from one generation to another. There is nothing in plan to stop or control it (Ng et al., 2010). This therefore means that individuals from families with history of hypertension are more at risk of hypertension than those with no history. Gender- men are more susceptible to hypertension than women. The fact that gender cannot be changed makes it had to control hypertension in male gender. The probability is also determined by age and ethnicity. Men prefer dealing with stress intrinsically rather than seek help from counselors or psychologists. Furthermore, men are known to have poor coping skills when under pressure than women (Mounier-Vehier et al., 2012). Age-older people have a greater risk of hypertension than young ones, aging brings with it a period of physical inactivity physiological as well as structural alterations of the cardiovascular system such as arteriosclerosis that make older people vulnerable to high blood pressure. In most cases, the systolic blood pressure is elevated, as one grows old. Aging is a progressive and irreversible process that people have no control of (Staessen, 2014). Race- Caucasians have a lower risk for hypertension than people of African origin do (Ugwuja et al, 2015). There is a presumption that Africans tend to develop increased blood pressure while still young and tend have a poor treatment outcome of hypertension than any other race. Socioeconomic status- for a long time hypertension has been the disease for those people with low social economic class that are either semi illiterate or illiterate. This is a possible explanation for the increased rates of hypertension in low-income countries (Cornwell & Waite, 2012). Poor living standards and low level of education have a direct link to hypertension. Poverty limits access to quality health services and frequent medical checkups and preventive services in the quest to prevent and treat non-communicable diseases such as hypertension. Controllable Factors Sodium intake- sodium is a key electrolyte that plays a role of determining the intracellular and extracellular fluid volumes. Increased sodium intake expands the haemodynamic volume that directly overworks the heart by increased heart rate and hitherto increased blood pressure in the ventricles (Faselis, Doumas, & Papademetriou, 2011). However, reduced sodium intake in dietary salt reduces the chances of hypertension. Bothe Processed food and over the counter drugs also are a source of high sodium when taken repeatedly and in large amounts causing a cumulative buildup of sodium in blood. Intake of sodium is controllable thus reducing the chances for hypertension (Moraitis & Stratakis, 2011). Physical inactivity- people with sedentary life styles often develop hypertension due to increased deposition of excess fat in the arteries narrowing the lumens increasing resistance to blood flow by extension causing elevated blood pressure (Oh, 2010). Obesity, which increases the risk of hypertension by six times, is a common phenomenon for those people who do not exercise. Stress- during emotional stress, hormones cortisol, and adrenalin are on release in large amounts that lead to increased heart rate, anxiety, and muscular tension. Uncontrolled stress make the heart overworked and sustained increase in blood pressure which when unchecked progress to hypertension (Stixrud, 2012). Alcohol intake-excess intake of alcohol more than two drinks in a day is known to cause hypertension to those individuals with alcohol sensitivity. Alcohol dependency has physiological effects on the cardiovascular system causing an increase in blood pressure (Briasoulis, Agarwal, & Messerli, 2012). Medications-regular and uncontrolled use of amphetamines and oral contraceptives cause increased blood pressure. Amphetamines cause over excitation of cardiac muscles that lead to increased heart rate. Why Hypertension is a Critical Issue Hypertension records some of the worst complications alongside the staggering number of annual deaths. Hypertension has its complications affecting virtually all body systems causing many disabilities if not death. Beginning with the cardiovascular system, hypertension is responsible for damaging arteries, creating aneurysm, coronary heart disease, enlarged left ventricle, and heart failure (The Lancet, 2014). Effects of hypertension to the brain include dementia, stroke, cognitive impairment, and transient ischemic attack. Kidneys remain vulnerable too; kidney failure can occur due to sustained high blood pressure limiting glomerular filtration, glomerulosclerosis is also common in hypertensive patients as well as kidney artery aneurysm due to increased pressure of main blood vessels in the kidney (Spence, 2012). Many patients with hypertension spend a lot of resources and time seeking medical services; this increases the economic burden to the whole family and the larger community. Antihypertensive drugs are expensive to acquire given that hypertension is a chronic disease a lot of money is used (Oliveras & Schmieder, 2013). Socially, hypertensive individuals feel unfit and often isolated in pleasurable activities that can exacerbate their condition. Restrictions on some diet come as a constant reminder of their unfit health in the family. Analysis shows that between 2011and 2025 the economic burden of hypertension in upper middle income, lower middle income, and low-income countries combined will amount to US$ 3.76 trillion. Current Status of Hypertension There has been a stable decline of hypertension cases from 1980 to 2008 as evidenced by the difference in the statistics. In 1980 deaths due to hypertension stood at 600 million people, year 2000 the death toll was 972 million and in 2008 the number was 1 million people (The Lancet, 2014). This is definitely an increase in the number of factors such as increased life expectancy and population growth rate largely contribute to the rise in number (Ferri, 2015). On the other hand, there are more advanced methods of dealing with hypertension today than it was in 1980s. In the WHO regions the prevalence of hypertension is high in Africa with the rate of 46% for both males and females while the lowest rates recorded in America; 35% prevalence for both sexes (UN System Task Team, 2012). With a lot of resources and effort directed towards combating non-communicable diseases under the Global Plan of Action intended to work from 2013-2020, hypertension has significantly reduced, since it is one of the significant public health threats that attracts full attention. It is estimated that if hypertension is uncontrolled, the mortality rate will increase by 60% accounting for 1.56 billion deaths in 2025, which is 10 years from now (Tibazarwa & Damasceno, 2014). This will be due to lack of appropriate policies on control of hypertension, unhealthy life styles, and other related factors that cause hypertension. Increased prevalence of hypertension has a direct relation to an increase in the socioeconomic burden, which infringes on other development plans of an individual and a country by extension (Tibazarwa & Damasceno, 2014). Potential Interventions for Hypertension Holistic approach in managing and preventing hypertension has proven fruitful, just like there are varied factors that cause hypertension there must be several approaches put in place to combat hypertension. An interdisciplinary approach that involves both public and private sectors must be employed (Woolf & Bisognano, 2011). Health practitioners, families, policy makers, and researchers must also take an active part in finding a long lasting solution for hypertension. When addressing hypertension through a collaborative team it is easier and cost effective in availing better preventive and curative options (Clark, Smith, Taylor, & Campbell, 2010). The government has the initiative of developing an integrated primary care program, creating cost effective implementation plan, availing basic medical-diagnostic methods, creating policies to reduce risk factors, encouraging work place fitness programs, and vigilant monitoring of the procession (Ferri, 2015). The health sector in conjunction with the social media and policy makers ,must create simple and elaborate healthy life style modification information encouraging the public to avoid obesity, engage in regular physical exercise, frequent blood pressure checkups, antihypertensive medication compliance, check on salt intake, and eat polyunsaturated fat as well as cut on alcohol consumption and smoking (Woolf & Bisognano, 2011) . Stress management techniques that involve meditation, group therapy, and cognitive behavioural therapy are known to lower stress hormone levels that directly influence hypertension. In the case of those individuals who already have hypertension, pharmacotherapy is a primary consideration in treating the disease and limiting the complications. Antihypertensive drugs are on routine administration to counter the effects of increased blood pressure while preventing complication. Patients are advised to comply to the regimen with direct observed therapy encouraged for those who are likely to default. Food and agricultural engineering sector must ensure production and selling of healthy food staff to the public (Cornwell & Waite, 2012). Polysaturated fats, cholesterol levels, and high sodium contents in food are monitored under the food quality control sector (Stolarz-Skrzypek, Bednarski, Czarnecka, Kawecka-Jaszcz, & Staessen, 2013). Antihypertensive medications have been used to treat hypertension and prevent complications associated with it. They include diuretics, which reduce blood pressure by lowering blood sodium levels therefore reducing blood volume. Direct vasodilators relax smooth muscles in the blood vessels lowering total peripheral resistance and improving capacitance. Sympathoplegic agents similarly reduce peripheral resistance while improving venous pooling. Angiotensin inhibitors lower peripheral vascular strain (Wang & Labarthe, 2011). For a long time a combination of these antihypertensive has proven effective (Wang & Labarthe, 2011). Nevertheless, this therapy does not prevent new cases of hypertension. To control effectively hypertension in the public, measures that are affordable and easy to implement are required. It is for this reason that life style modification is optimistically anticipated to lower the prevalence of hypertension. Controlling weight, limiting salt intake to 5g per day and regular physical excise are the best formation available for preventing hypertension (Elhani, Cleophas, & Atiqi, 2009). In conclusion, hypertension requires united effort of the government, public health sector, medical practitioners, agricultural engineering, and production as well as the cooperation of the public to adequately prevent and treat it. Relying on pharmacological approach alone without considering hypertension as a condition that demand a holistic approach seems to worsen the situation. The government must support the public health sector by enacting laws that prohibit selling of unhealthy food and excessive alcohol drinking and smoking. Sodium content in food must be in limited amounts. The health sector has the responsibility of educating the public on the importance of regular physical exercise, healthy diet, and stress management. References list The Lancet. (2014). Hypertension: an urgent need for global control and prevention. Lancet, 383, 1861. doi:10.1016/S0140-6736(14)60898-9 Brady, T. M. (2012). Hypertension. Pediatrics in Review / American Academy of Pediatrics, 33, 541–52. doi:10.1542/pir.33-12-541 Briasoulis, A., Agarwal, V., & Messerli, F. H. (2012). Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. Journal of Clinical Hypertension (Greenwich, Conn.), 14, 792–8. doi:10.1111/jch.12008 Clark, C. E., Smith, L. F. P., Taylor, R. S., & Campbell, J. L. (2010). Nurse led interventions to improve control of blood pressure in people with hypertension: systematic review and meta-analysis. BMJ (Clinical Research Ed.), 341, c3995. doi:10.1136/bmj.c3995 Cornwell, E. Y., & Waite, L. J. (2012). Social network resources and management of hypertension. Journal of Health and Social Behavior, 53, 215–31. doi:10.1177/0022146512446832 Elhani, S., Cleophas, T. J., & Atiqi, R. (2009). Lifestyle interventions in the management of hypertension: a survey based on the opinion of 105 practitioners. Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 17, 9–12. doi:10.1007/BF03086208 Faselis, C., Doumas, M., & Papademetriou, V. (2011). Common secondary causes of resistant hypertension and rational for treatment. International Journal of Hypertension, 2011, 236239. doi:10.4061/2011/236239 Ferri, F. F. (2015). Ferri’s Clinical Advisor 2015. In Ferri’s Clinical Advisor 2015 (p. 411). Moraitis, A., & Stratakis, C. (2011). Adrenocortical causes of hypertension. International Journal of Hypertension, 2011, 624691. doi:10.4061/2011/624691 Mounier-Vehier, C., Simon, T., Guedj-Meynier, D., Ferrini, M., Ghannad, E., Hubermann, J. P., … Guenoun, M. (2012). Gender-related differences in the management of hypertension by cardiologists: The PARITE study. Archives of Cardiovascular Diseases, 105, 271–280. doi:10.1016/j.acvd.2012.03.003 Myat, A., Redwood, S. R., Qureshi, A. C., Spertus, J. A., & Williams, B. (2012). Resistant hypertension. BMJ (Clinical Research Ed.), 345, e7473. doi:10.1136/bmj.e7473 Ng, K. H., Stanley, A. G., & Williams, B. (2010). Hypertension. Medicine. doi:10.1016/j.mpmed.2010.05.001 Oh, M. K. (2010). Secondary hypertension. Korean Journal of Family Medicine. doi:10.4082/kjfm.2010.31.6.420 Oliveras, A., & Schmieder, R. E. (2013). Clinical situations associated with difficult-to-control hypertension. Journal of Hypertension, 31 Suppl 1, S3–8. doi:10.1097/HJH.0b013e32835d2af0 Spence, D. (2012). Why do we overtreat hypertension? BMJ. doi:10.1136/bmj.e5923 Staessen, J. (2014). Hypertension. Age-specificity of blood-pressure-associated complications. Nature Reviews. Cardiology, 11(9), 499-501. Stixrud, W. R. (2012). Why Stress Is Such a Big Deal. Journal of Management Education. doi:10.1177/1052562911430317 Stolarz-Skrzypek, K., Bednarski, A., Czarnecka, D., Kawecka-Jaszcz, K., & Staessen, J. A. (2013). Sodium and potassium and the pathogenesis of hypertension. Current Hypertension Reports. doi:10.1007/s11906-013-0331-x Tibazarwa, K. B., & Damasceno, A. A. (2014). Hypertension in developing countries. Canadian Journal of Cardiology. doi:10.1016/j.cjca.2014.02.020 UN System Task Team. (2012). Health in the post-2015 UN development agenda. Thematic Think Piece. World We Want 2015 [online] (pp. 1–17). Ugwuja, E., Ezenkwa, U., Nwibo, A., Ogbanshi, M., Idoko, O., & Nnabu, R. (2015). Prevalence and determinants of hypertension in an agrarian rural community in Southeast Nigeria. Annals of Medical and Health Sciences Research, 5(1), 45. Wang, G., & Labarthe, D. (2011). The cost-effectiveness of interventions designed to reduce sodium intake. Journal of Hypertension, 29, 1693–1699. doi:10.1097/HJH.0b013e328349ba18 Woolf, K. J., & Bisognano, J. D. (2011). Nondrug interventions for treatment of hypertension. Journal of Clinical Hypertension (Greenwich, Conn.), 13, 829–35. doi:10.1111/j.1751-7176.2011.00524.x Read More