Hypertension as a Chronic Medical Condition - Case Study Example

Hypertension Name Date Course Hypertension Introduction Hypertension is a chronic medical condition whereby the blood pressure in the arteries is elevated. It can be expressed in two measurements which includes the systolic and diastolic pressures. The systolic pressures usually occur during the contraction of the left ventricle. The diastolic pressure occurs during the relaxation of the left ventricles. The normal blood pressure is usually 100-140 mmHg but in the case of an individual with hypertension, their blood pressure is at or above 140/90 mmHg. Hypertension does not present any symptoms during the initial stages. However, sustained hypertension is a Major health risk to the individual. Sustained Hypertension is known for causing coronary heart disease, hypertensive heart disease, stroke, chronic kidney disease, peripheral heart disease and aortic aneurysm (Porth & Matfin, 2005). Hypertension can be described as primary or secondary depending on their causes. Hypertension is considered primary when it does not have an underlying cause but is considered secondary when it has an underlying cause. In order to manage hypertension, dietary and lifestyle changes have to be made by the individuals. Hypertension is one of the conditions that are known for pathophysiology. The paper thus discusses the pathophysiology of hypertension in relation to an individual who has hypertension. Discussion Pathophysiologies presented by a person The increased resistance to blood flow is one of the main pathophysiologies of hypertension. The condition is also regarded as total peripheral resistance and it accounts for high pressure with the cardiac output remaining normal. The cardiac output usually falls while the peripheral resistance usually increases with age. This pattern is common among most of the people with hypertension. Increases peripheral resistance can be attributed to the structural narrowing of the small arteries and arterioles. The individual with hypertension also experience a decrease in peripheral venous compliance. An increase in the cardiac preload is also common for the individuals with hypertension. This condition is risky as it causes diastolic dysfunction. A condition that is known as isolated systolic hypertension is also part of the pathophysiology. It is characterized by high systolic pressure and low diastolic pressure (Persell, 2011). Hypertension usually exacerbates arterial stiffness which is also considered a high risk for the individuals. Endothelial and vascular inflammation arterial also common with hypertension and it is associated with the increase in the peripheral pressure. The vascular damage is also common in the individual with hypertension. Most of the pathophysiologies of hypertension may be observable but other may not be observable until at an advanced stage. Difficulty in breathing is also one of the vital signs of hypertension when it is at an advanced stage. The chest pain can also be experienced together with the difficulties in breathing due to heart failure. Kidney failure on the other hand results to a feeling of malaise. The patient with hypertension may also experience constant headache which is accompanies with heaviness in the head. As a result of the heaviness in the head and severe headache, the movement of the individual becomes sluggish. General redness of the body may also be experienced and it may also be accompanied with warm to touch feeling of the body as a result of the high blood pressure (Witkowski, 2011). The vessels usually become tense as a result of the increased resistance to blood flow. The urine usually appears coloured dense with the distention of the skin taking place which can be attributed to poor functioning of the kidney. The individual may also face weak eyesight and impairment in terms of thinking which is as a result of poor circulation of blood. The excess amount of blood within the vessel results to hemorrhagic stroke. Expected clinical presentation after a person has been treated When the treatment has not been carried out, the resistance to blood flow is high and inflammation of the blood vessels is also common. However after treatment which involves the use of medication, the resistance to blood flow is expected to reduce considerably and hence enabling the individuals to carry out their duties normally. This is considering that the main goal of treatment is to lower the high blood pressure and protects some of the vital body organs that may end up being damaged as a result of high blood pressure. The chance of stroke is high before the treatment of the patient. However, after treatment, the chance of stroke is reduced by 35-40%. The chances of heart attack are also reduced by 20-25%. Research also indicates that the treatment of hypertension usually result to the reduction in the chances of heart failure by 50% (de la Sierra, et al, 2011). Before the treatment of hypertension, the blood pressure is usually greater than 140/90 mmHg. However after treatment it is expected that the blood pressure will be lowered to a range of 100-140 mmHg. The kidney functions are usually affected before the treatment of the hypertension. However, after the treatment of hypertension, the kidney function is restored leading to improvement in cardiac output, reduced vascular resistance and normalcy in the blood retention. Excess activities at the sympathetic nervous system are usually expected before the treatment of hypertension. This is however reduced after the treatment process leading to the reduction in the high blood pressure. Etiology The individual has a chronic hypertension which is can be associated with primary hypertension. Primary hypertension is as a result of complex interaction between the genes and environmental factors. The individual is aging and hypertension is also known to rise with age. One of the main primary causes of hypertension is high intake of salt (Harrison, 2011). Lack of exercises as well as obesity and stress could be associated with the condition that the patient is facing. This is considering that the obesity and stress can be attributed to the lifestyle of an individual. Other possible factors of hypertension also include deficiency of vitamin D and consumption of caffeine which is a common practice among most people. The primary hypertension may also be as a result of factors such as low birth weight, maternal smoking and lack of breastfeeding. The primary sources of hypertension are the leading cause of hypertension for most of the individuals with the condition. The environmental factors that contributes to hypertension can however be avoided with availability of adequate information. Treatment options Various treatment options are in place for the people with hypertension. Treatment can be carried out through the use of medication as well as therapeutical approach. The therapeutical treatment involves the activities that are aimed at changing the lifestyles of the individuals. The individuals who have hypertension are usually encouraged to avoid sexual intercourse and they are also supposed to control their anger and avoid it as much as possible. Dietary programs for the individuals can also be put in place for the purposes of managing the condition. The consumption of meat, wine and pastries has to be avoided. Low energy diet is also encouraged for the individuals as a means of therapeutical treatment. Several medications can also be administered to the individuals with hypertension. The most common form of medication for hypertension includes antihypertensive medication. However, when using the medications, the cardiovascular risks have to be considered. The physician is however required to monitor the response of the patient to the medication. This is because of side effects that may be witnessed by the patient. Calcium Channel blockers (CCB) can be used during the treatment of individuals who are above the age of 55 years (Verdecchia, et al, 2012). Angiotensin converting enzyme inhibitors (ACE-I), is recommended for younger people. Treatment option for the individual Currently the patient is using Calcium Channel Blocker for the purposes of treatment. The specific Calcium Channel Blockers that the individual is using is called Norvasc. The drug is usually taken once on a daily basis which is the direction that was provided by the doctor. This medication is usually taken through the mouth with or without food (Pedrosa, 2011). It is recommended that this medication should be taken on a daily basis even when the individual is feeling well. When using this type of drug, the doctor has to monitor the conditions in order to determine if any changes is taking place. The dosage may be increased in case there is no change with regards to the blood pressure. The individual has seen some changes with the use of Norvasc. There are various types of Calcium Channel Blockers but Norvasc was the most convenient to the individual and it is readily available. Options that are available and are not in use Combined medication and use of therapeutical treatment is the main option that is available to the individual. The combined medication involves the use of more than one medication in order to effectively control hypertension. The combined medication involves the use of thiazide, ACEI, ARB or CCB. It is also recommended that combination of ACEI and CCB can be used. However, care should be taken when using combined medication. This is because some of the combinations may lead to kidney failure and hence reducing the chances of survival of the patient (Barhoumi, et al, 2011). A combination of ACEI and NSAID should be avoided as it increases the chances of kidney failure. The use of combined medication with the medicines that contains vasoactive agents should be avoided for people with pulmonary hypertension. The use of therapeutical treatment will mainly involve the observing the diet and carrying out exercises on a regular basis. Currently, the individual is not using the combined medication due to the expenses that are involved in the purchase of the drugs and lack adequate information. This method cannot be affordable to most of the people who may be of low income. The drugs are required on a daily basis which makes it more expensive. The individual is not fully using the therapeutical treatment due to lack of proper information on how it can be carried out. The individual also lacks adequate support to carry out some of the activities such as carrying out exercises on a daily basis. Strategies to enable the individual use the additional option Although the individual is responding well to the current medication being used, it would be better for the additional option to be considered. The first step will involve providing adequate information to the individual about the combined medication and therapeutical treatment. A person with hypertension requires adequate information in order to better manage the condition (Samuelsson, et al, 2013). The social worker can also be involved in the process of providing the individual with the required help on a regular basis. This is especially on the aspects of therapeutical treatment. The community health nurse can also be involved by visiting the individual at least one every week. The involvement of the professionals will play an essential role in creating a better understanding by the patient on the condition. On the issues of combined medication, the individual will be required to obtain a medical insurance cover. This will enable the individual to access the combined medication. A medical health insurance cover is important for the people with long term conditions such as hypertension as it may require long term medication as part of the intervention. Actual Complications and Treatment Options As a result of the treatment options, several complications may be witnessed and it can affect the management process. Dizziness, nausea and dry mouth may be witnessed by the individual while using the medication. This may however last for a short period of time and adequate rest is recommended in order to deal with the dizziness. The swelling of ankles, feet and lower legs is also expected when using the medication (Dimeo, et al, 2012). This will however require the directions of the doctor to recommend the appropriate solution. Frequent headache and fatigues may also be experienced from time to time. Pain killers that have been recommended by the doctor may be administered to reduce the pain or frequent headaches. During the process, the individual should not take alcohol as it interferes with the effect of the drug and it increases the side effects. Grape juice should also be avoided as it also affects the action of the drug. List of References Porth, C, & Matfin, G, 2005, Pathophysiology: Concepts of altered health states (Vol. 781749883), Lippincott Williams & Wilkins. Persell, S, D, 2011, Prevalence of resistant hypertension in the United States, 2003–2008, Hypertension, 57(6), 1076-1080. Witkowski, A, 2011, Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea, Hypertension, 58(4), 559-565. de la Sierra, A, et al, 2011, Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring, Hypertension, 57(5), 898-902. Harrison, D, 2011, Inflammation, immunity, and hypertension, Hypertension, 57(2), 132-140. Verdecchia, P, et al, 2012, Day-night dip and early-morning surge in blood pressure in hypertension prognostic implications, Hypertension, 60(1), 34-42. Pedrosa, R, P, 2011, Obstructive sleep apnea the most common secondary cause of hypertension associated with resistant hypertension, Hypertension, 58(5), 811-817. Barhoumi, T, et al, 2011, T Regulatory lymphocytes prevent angiotensin ii–induced hypertension and vascular injury, Hypertension, 57(3), 469-476. Samuelsson, A, et al, 2013, Experimental hyperleptinemia in neonatal rats leads to selective leptin responsiveness, hypertension, and altered myocardial function, Hypertension, 62(3), 627-633. Dimeo, F, et al, 2012, Aerobic exercise reduces blood pressure in resistant hypertension, Hypertension, 60(3), 653-658. Read More