Hypertension A Case Study

1. HypertensionA Case Study Jennifer Kitchen July 19, 2013

2. Vicki, a patient just diagnosed with Hypertension (HTN) • What is Hypertension? • Appropriate Treatment Prognosis (including therapies, medications, etc.) • Patient Teaching • Potential Barriers to Therapy Overview

3. 42 years old • African American • Married to her high school sweetheart, Robert, for 20 yrs. • Self-employed, successful insurance agent • Busy lifestyle, travels often and eats at fast food restaurants for most meals • Blood pressure, 145 over 94 Vicki

4. Hypertension (HTN) is… • High Blood Pressure (BP) • A major cause of strokes and heart attacks • 1 in 4 adults have high BP • An estimated 5-10 million people have HTN but are unaware of it • HTN contributes Directly or Indirectly to almost 800,000 deaths a year • (Moser, 2012) What is Hypertension?

5. Normal BP is about 120/80 • Systolic pressure- pumping pressure • Diastolic pressure- resting pressure • (ACP, 2004). Normal Blood PressureWhat is Hypertension?

6. Table 1: Stages of hypertension Stage SystolicDiastolic Optimal <120 <80 Normal 120–12980–84 High-normal 130–139 85–89 HTN stage 1 140–159 90–99 HTN stage 2 160–179 100–109 HTN stage 3 >180 >110 Systolic and diastolic pressures given in mm Hg. (Foex, 2004) Stages of Hypertension What is Hypertension?

7. HTN is not curable • Can be controlled with… • Medication (drug therapy) • Diuretics, Beta-adrenergic blockers, Vasodilators, Calcium channel blockers, Angiotension-converting enzyme (ACE) inhibitors, and Angiotension receptor blockers (ARBs) • Lifestyle changes • Limit sodium intake, Reduce and maintain a healthy weight, Manage a healthy diet, Exercise, Reduce stress, and Quit smoking • (Frazier and Drzymkowski, 2009) Treatment Prognosis

8. Cause of HTN is Unknown, but many factors may contribute to HTN… • Age, Smoking, Heredity, Obesity, Sedentary lifestyle, Poor diet and nutrition, and Hyperactive (type A) personality • Stress is considered a Major Factor! • (Frazier and Drzymkowski, 2009) Patient Teaching

9. Living with HTN… • Remember high BP cannot be Cured, only Controlled • Drug therapy is important in helping control HTN • Lifestyle changes are also important • BP must be monitored regularly • (Frazier and Drzymkowski, 2009) Patient Teaching

10. Making lifestyle changes • “Bad habits are hard to change.” • Staying on medication • “If I can’t feel it, it must not be there.” • Monitoring BP • “My blood pressure is always higher when I go to the doctor’s office.” Potential Barriers

11. Sometimes all we need is to take a break on the busy tracks of life.

12. American College of Physicians (ACP), (2004). ACP Special Report: Living With Hypertension. Retrieved from http://www.acponline.org/patients_families/pdfs/health/hypertension_report.pdf Foex, P. and Sear, J.W., (2004). Hypertension: pathophysiology and treatment. Continuing Education in Anesthesia, Critical Care & Pain; 4:3. DOI 10.1093. Retrieved from http://ceaccp.oxfordjournals.org/content/4/3/71.full.pdf+html. Moser, M. (2012). High Blood Pressure: lower it and live longer. Hypertension Education Foundation (HEF). Retrieved from http://www.hypertensionfoundation.org/PDinfo/HBP(HEF)120611.pdf Frazier, M. S. and Dryzmkowski, J. W. (2009). Essentials of Human Diseases and Conditions (4th Ed.). St. Louis, MO: Saunders Elsevier Inc. References