Risk Factors and Prevention of Hypertension - Essay Example

Hypertension Student’s Name Institutional Affiliation Table of Content Table of Content 2 Introduction 3 Disease Burden and its Determinants 3 Risk Factors for Hypertension 5 Prevention of Hypertension 6 Conclusion 7 References 8 Hypertension Introduction Hypertension caused by a chronically high blood pressure (BP) is defined as a systolic and diastolic pressure exceeding or equal to 140mmHg and 90mmHg respectively or a patient on medication for managing high BP (Australian Institute of Health and Welfare [AIHW], 2012). The condition generally progresses from a normal blood pressure to prehypertension, culminating in stage 1 and later stage 2 hypertension if the BPs are not sufficiently controlled in time (Madhur, 2014). Hypertension is also a secondary cause of various other cerebrovascular diseases, organ diseases including heart and kidney diseases and other cardiovascular diseases (Ghezelbash & Ghorbani, 2012). The disease has a significant detrimental impact on the Australian population since it is associated with relatively high morbidities, mortalities and management costs (Australian Bureau of Statistics [ABS], 2013). Disease Burden and its Determinants High BP is ranked among the highest risks of health in Australia. The burden of disease resulting from high BP can be estimated in terms of "Disability Adjusted Life Years [DALYs]" (AIHW, 2012, p. 116). The higher the DALYs, the greater the severity or negative impact of the disease. In a study done in 2003 high BP was concluded to be the second most causative risk factor of disease burden in Australia causing an estimated 8% of disease burden (Begg et al., 2007). Between 1999 and 2000 it was estimated that about 3.7 million Australians forming 30% of the Australian population aged at least 25 years experienced high BP (AIHW, 2012). Among this population, 27% of women and 32% of men had hypertension. The AIHW (2010) revealed that there was not a marked change in the prevalence of high BP among Australians aged at least 25 years only slightly decreasing from 31% to 30% over a five-year period from 1995 to 1999-2000 respectively. Studies demonstrating a long-term trend in changes in high BP among Australians are limited, with the available study showing a significant 50% drop in the prevalence of high BP among Australians aged 25-64 living in urban areas (AIHW, 2010). This decline was experienced over two decades from 1980 to 2000. Recent statistics suggest that as of 2011-12, hypertension was common among a third of adult Australian population with 68% of the population having uncontrolled high BP and the remaining 38% having normal BP but on antihypertensive medicines (ABS, 2013). Tasmania had the highest prevalence of uncontrolled high BP at 30% while this was least prevalent in Northern Territory at 16% (National Heart Foundation of Australia [NHFA], 2012). The likelihood of more men to have unmanaged high BP than women was estimated to be at 23.6% and 19.5% respectively (NHFA, 2012). The condition was more common in older age groups as it was present in about 87.7% of Australians aged at least 85 years during the same period (ABS, 2013). Australian staying in metropolitan areas had a lower likelihood of having high BP (31.3%) than their regional counterparts (34.2%) as per a 2011 study (NHFA, 2012). This demonstrates that socioeconomic factors determine the prevalence of high BP among Australians. Other common determinants of high BP include behavioral and biological determinants (Fleming & Parker, 2011). Among behavioral determinants include alcohol consumption, tobacco smoking, high-fat diet and physical inactivity (Boyden, Anderson, Couzos & Cadilhac, 2012). A significant biological determinant of high BP is family history of hypertension (Madhur, 2014). Moreover, some of the determinants are interrelated such that a behavioral determinant such as physical inactivity and high fat diet that may result in obesity may have their effects aggravated by biological determinant such as genetic predisposition to obesity (Madhur, 2014; Fleming & Parker, 2011). Risk Factors for Hypertension Factors predisposing to the development of hypertension may be grouped into two – modifiable and non-modifiable factors. "Modifiable risk factors are those that an individual" can control while the non-modifiable factors are independent of the influence of an individual (Boyden et al., 2012; Ghezelbash & Ghorbani, 2012). Modifiable risk factors include overweight or obesity, physical inactivity, high salt intake, high alcohol intake, stress, diet deficient in potassium and occurrence of chronic conditions such as kidney diseases (Boyden et al., 2012). Overweight and physical inactivity are interrelated as the former is known to increase the risk of obesity cumulatively increasing the risk of high BP. Chronic illnesses including diabetes and chronic kidney disease predispose individuals to hypertension due to the pathological implications of such chronic illnesses (Wang et al., 2006). Cigarette smoke can also be classified as an environmental risk factor if non-smokers inhale cigarette smoke from their environment (Ghezelbash & Ghorbani, 2012). This is termed passive smoking, and it may also have effects similar to those experienced by an active smoker. Risk factors unmodifiable by an individual include age. Incidence of high BP are common with increased age, and the incidences are higher in men aged 45 and above compared to women but the reverse is true for ages above 65 (NHFA, 2012). Other uncontrollable risk factors include family history and race. People from families with a genetic predisposition to high BP are at an about 40% risk of having hypertension while, globally, certain races such as black adults are at high risk compared with other races (Madhur, 2014). In Australia the “Aboriginal and Torres Strait Islanders [ATSI]” have a two to three times risk of developing hypertension compared to the Caucasian Australian population (Boyden et al., 2012). This was demonstrated in a 1989 study on Kimberley Aboriginal Population (Boyden et al., 2012). Wang et al., (2006) supported the assertion that race is a risk factor for high BP. The study’s findings suggested that between 1993 and 1997, the prevalence of hypertension in the ATSI population aged 25-54 years was higher at 27% than among non-indigenous population with a prevalence of 9% (Wang et al., 2006). Prevention of Hypertension The primary preventive measures against hypertension are aimed at individuals with normal BP – less than 120mmHg and 80mmHg of systolic and diastolic pressures respectively (Madhur, 2014). The prevention strategies can target high-risk persons or the general population. One major primary prevention initiative is through policy interventions (World Health Organization [WHO], 2013). Primary preventive measures targeting reduction of tobacco use may include an increase in excise tax on tobacco products to make it costly for individuals contemplating starting to smoke (WHO, 2013). An introduction and enhancement of policies requiring public places and workplaces to be smoke-free will reduce active smoking and secondary smoking. Moreover, warnings and health information regarding the dangers of tobacco to an individual's health will educate individuals and persuade some not to indulge in the habit. Finally, the government can ban activities geared at promoting or advertising tobacco use so that fewer individuals are interested in using tobacco (WHO, 2013). A reduction of harmful consumption of alcohol will also lower the risk for hypertension. Tax increment on alcoholic drinks, a comprehensive and strict restriction and prohibition of alcohol marketing activities, and restricting or limiting the availability of alcoholic drinks in retail shops are all public health measures that are useful in primary prevention of high BP (WHO, 2013). Physical inactivity and unhealthy diets such as diet rich in fats and salt can all be improved to prevent the development of prehypertension or even hypertension. Public health measures targeting such risk factors include mass-media campaign encouraging salt reduction in home diet and processed food in the food industry, utilization of poly-unsaturated fats over trans-fats, and implementing an awareness program in the public about healthy diet with less sodium and more potassium rich foods and the significance of physical activity (WHO, 2013) Secondary prevention measures are aimed at preventing or delaying the progress of an already developing hypertension at the pre-hypertension stage – BP of between 120-139 systolic and 80-89 diastolic (Madhur, 2014). Secondary public prevention measures are commonly similar to primary prevention initiatives, but they target the pre-hypertensive people. Such measures include reduction or elimination of risks such as tobacco smoking, alcohol consumption and encouraging healthy diets and exercise (Ghezelbash & Ghorbani, 2012). This is achievable through public policies and campaigns routinely to identify pre-hypertensive individuals at medical camps and health institutions and implementing the secondary prevention strategies (WHO, 2013). Tertiary prevention strategies target individuals with developed hypertension be it in stage 1 or 2. Such individuals require specialized care of health service providers in addition to their own efforts to control the aggravation of hypertension. Public health tertiary prevention strategy include public campaigns to encourage such individuals to seek assistance from medical service providers (Boyden et al., 2012). Other strategies include empowering health workers at all care levels with sufficient skills and knowledge of managing hypertensive patient through training and awareness on hypertension and recent developments on hypertension (WHO, 2013). In addition, standard hypertension management guidelines should be provided by governmental public health service to guide health workers in managing hypertensive patients (WHO, 2013). Conclusion High BP is a condition with a significant disease burden in Australia. The condition's modifiable risk factors are a target for prevention of its occurrence. Early detection and control of an already progressing hypertension is essential to managing the condition. Public health measures are instrumental in controlling upstream, midstream and downstream factors associated with hypertension. References Australian Bureau of statistics. (2013). Australian health survey: Health service usage and health related action, 2011-12. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/322DB1B539ACCC6CCA257B39000F316C?opendocument Australian Institute of Health and Welfare. (2010). Australia's health 2010. Canberra: AIHW. Australian Institute of Health and Welfare. (2012). Australia's health. Canberra: AIHW. Begg, S., Vos, T., Barker, B., Stevenson, C., Stanley, L. & Lopez, A.D. (2007). The burden of disease and injury in Australia in 2003. Canberra: AIHW. Boyden, A., Anderson, S., Couzps, S. & Cadilhac, D. (2012). High blood pressure (Hypertension). Retrieved from http://www.carpa.org.au/Ref%20Manual%204th%20Ed/Chronic%20disease/High_blood_pressure.pdf Fleming, M.L. & Parker, E. (2011). Introduction to public health (2nd ed.). Chatswood, NSW: Elsevier Australia. Ghezelbash, S. & Ghorbani, A. (2012). Lifestyle modification and hypertension prevention. ARYA Atherosclerosis Journal, 8(Special Issue in National Hypertension Treatment ), s202-s207. Madhur, M.S. (2014). Hypertension. Retrieved from http://emedicine.medscape.com/article/241381-overview#aw2aab6b2b2 National Heart Foundation of Australia. (2012). High blood pressure statistics. Canberra: NHFA. Wang, Z., Knight, S., Wilson, A., Rowley. K.G., Best, J.D., McDermott, R., ... & O'Dea, K. (2006). Blood pressure and hypertension for Australian Aboriginal and Torres Strait Islander people. European Journal of Cardiovascular Prevention and Rehabilitation, 13(3), 438-43. World Health Organization. (2013). A global brief on hypertension. Silent killer, global public health crisis. Geneva: WHO. Read More