Prevention of Hypertension in Adult Population - Essay Example

Prevention of Hypertension in Adult Population of America Inserts His/Her Inserts Grade Inserts 4July 2008 Prevention of Hypertension in Adult Population of America Hypertension is an important contributor to morbidity and mortality from cardiovascular disease, and there is steady increase of persons receiving treatment for hypertension, during the past four decades, that led to reduction in hypertension, and thereby incidence of associated cardiovascular disorders. Approximately “50 million Americans suffer from hypertension”, and it is one of the prime risk factors for major cardiovascular diseases, which are leading causes of death among people under the age of 60 in most countries. (Focus on cardiovascular disease, 2007). The measurement of blood pressure is a complex topic, and there is also no exact differentiation between individuals ‘at risk’ from blood pressure-associated morbidity and mortality, and rest of the population. Adequate treatment of High Blood Pressure (HBP) with strict adherence to regimen, better prescribing and compliance, and regular follow-up is expected to reduce the risk of stroke and cardiovascular episodes. However, literature reviews suggest that healthcare outcomes and patient compliance are not up to the expected level due to several barriers to the successful diagnosis, treatment, and control of hypertension encountered by healthcare providers and lack of compliance by patients with hypertension. Research findings also suggest that there is disagreement among physicians regarding definitions of hypertension, and confusion over medications for BP control. As such, it is essential to maintain uniformity in research standards and clinical approaches to improve the quality of care for controlling patient’s blood pressure and introduce nurse-led blood pressure management initiative, to attain the goals of Healthy People as envisaged. Research Findings on Prevalence of Hypertension in the U.S Hypertension is prevalent in “28% of the US population and 35% of the African American population. However, only 1 in 4 patients with hypertension are controlled to a blood pressure of less than 140/90 mm Hg.” (Wright et al, 2002, p.1636-1643). Cross-sectional analysis of national representative data by Wang & Wang (2004), conforming to new classification of blood pressure levels by Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure report (JNC 7 Report published in 2003), found that “elevated blood pressure is a serious problem in the United States. Approximately 60% of American adults have pre-hypertension or hypertension, and some population groups, such as African Americans, older people, low-socioeconomic-status groups, and overweight groups, are disproportionately affected.” (Wang & Wang, 2004, p.2126-2134). African Americans develop hypertension at a young age and it is more prevalent than whites. The low control of hypertension rates in the United States is attributed to “inappropriate or inadequate treatment, non-adherence with medical regimen, intake of exogenous substances that interfere with the antihypertensive regimen, biologic factors associated with resistance, and secondary forms of hypertension.” (Wright et al, 2002, p.1636-1643). Analysis of data from the National Health and Nutrition Examination Surveys (NHANES) for 1999-2002 by CDC found that “proportion with controlled BP was similar among non-Hispanic blacks (29.8%) and non-Hispanic whites (29.8%), but substantially lower among Mexican Americans (17.3%),” which demonstrate continuing racial and ethnic disparities in the prevalence of hypertension and in the percentage of those with HBP who are aware of, are being treated for, and are in control of their condition. (Racial/Ethnic disparities in prevalence, treatment, and control of hypertension—United States, 1999-2002, 2005, P.923-925). Since High Blood Pressure (HBP) usually has no signs or symptoms the National Health Objectives for 2010 against this “silent killer” include reducing the proportion of adults with HBP to 16% (baseline: 28%), increasing the proportion of adults with hypertension who are taking action to control it to 95% (baseline: 18%). The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that ‘public health officials and clinicians need to increase their efforts to treat and control BP levels among persons with hypertension, and promote physical activity, nutrition changes (e.g. reducing high salt/sodium), weight reduction or management, stress reduction, and routine BP screening’ for reducing disparities and improve HBP prevention and control among U.S adults. What is Hypertension? “Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps out blood, and blood pressure rise staying elevated over time is called ‘high blood pressure,’ which can damage the body in many ways. Blood pressure numbers include systolic and diastolic pressures, where they represent the pressure when the heart beats while pumping blood and when the heart is at rest between beats, respectively. Blood pressure can remain unknown for years, because it usually has no symptoms and tends to rise with age. Unnoticed high blood pressure can damage the heart, blood vessels, kidneys, eyes, and other parts of the body. Hence, knowing blood pressure number and regular checking is important to reduce risks and complications of ‘hypertension’ (medical term for high blood pressure). The measurement of blood pressure is a complex topic as it can vary from one instant to the next, changes depending upon the time of day, and is affected by environmental, physical, and psychological conditions. The quality of BP measurement may also vary depending on the person’s ability and level of training who takes the measurement as well as faulty instruments. “The World Health Organization defined ‘hypertension’ as: systolic blood pressure greater than or equal to 160 mmHg and/or diastolic blood pressure (fifth phase) greater than or equal to 95 mmHg, and ‘borderline hypertension’ as …systolic 141-159 and diastolic pressure Read More