,-
=-iyperte:'l:::;j.o~!
An
:
[\ Controllable Froblem?
-,
(ID 4-99)
~:.onors
3y
Patricia An:!
-
--
~hesis
~Tapier
Fayntor
Director
The completion of tilis thesis depended upon t:le
assista:'Lce oi' :,':rs. :"TiL-:oi te.
1"'e
\I!~ci ter
appreci2.ti ve of tl-:0 time, patience, and
~iven
~rom
the
sta~t
of the paper to
t~e
is deeply
encoura,~·er;].ent
finis~.
P.A.F.
-
ii
-
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~lYP ert ens i o'~~
~ors9,
,
~e~2r
than
~al~ o~ t~ern
know it
(Galto~,
chronic diseases in persons over 40 years
i:';.cid'c::ce of heart at-tac 1c •
f:~tr01ce,
1973: p.
o~ a~e,
and Jddney
1
\
.l. J
•
and if
failu:~e.
A perso~'8 blood pressure is ~easured ~y use of a
consicts of a
(1).:~"~,
mercu.ry coILI.mn, and aulo.
applied_co ti-:e pc?rsol1' s arm and filled
pressure is applied to
t~e
':,-i tll.
air 1.ul.til
underlyinc artery.
As air is
stethoscope is used to listen for the sounds caused by
rhe sounds, recorded in l:.:';.its of ",nm
=.1
t~e
"
(::r :l.11i;(~ct8r8
colU.m:l.
'~l:.e
.L'ir:::t
GO'Jx'_o
~1eard
represents the :-Teatest
In an Gxa:d.:::a-
systo15.c
:pref:~;::,;)re
~he
is 120 ::e:l"::
~I~'
and tr:e c1iastolic pressure is 30
systolic pressure is caused by
t~e
co:::tracts to send 'olood
tension in
t~e
~n::n
arteries
ttl.S blood.
2
~~e
"\Tosscl: .
~lood
diastolic pressure
for the next
indicates the period
~eat.
blood pressure
~~e
:~;
deviations arc determined.
follov:i:J~"
accept;::; tIle
elevatio:-;.
~eard
is
]orld : ealth Or:anization
~~e
defini tior: for
~lypertension,
or an
blood pressv.re as:
i~-;.
a p~rsistent elevation of t~e systolic blood pressure
above lho 1:"1T1 ~:-" and of the diastolic pressure above
}.,.-.: ... ~
r
:7,-, H1L' 'i~,_ ("I,
.1.t_,
___. L.la._.~
c~.lG
. . . . or . . . . . . u,o~.
. . _.. , 1 :J( , . p . G'77
. . ,)/ i\ ·
("'\0,
-
-.-.,y'"
-'Le.
1n
r8adi~:
"t ......
\
t~at
swinmin~',
nat1.1ra=~1~r
ti~f.es
:1
":,
0;"-\>::,"1
nr;[l, I
-.
it is easily affected by rapid and frequent
chances in activity,
jO~~'in~,
0:1'
o~otio~s,
and the time of day.
or experiencin: aneer.
The tlood pressure
rises to meet t;-;,e body s :--ceeds and at di:fferent
I
of t:le cay.
Tt is
re~ai~s
~hen
tte blood pressure
elevated even at periods of rest that
'8r. J. Sta.'111c:c, p:co:essor a!'.d chairman
.-
hypertensio~
0::
l,iort}:v!ester"J
J
~?
.~- X
x
~:.
1
of all :lypertens i 'les are undetected,
-:{
of tll0se who are (l etected '~~o untreated, and only about
1:
of t~ose receivin~ treatment are cetting adequate care
",
(l:erc k , Sl- arp, - and Doh:rne, 1971.(: p. 21).
-
There:ore, 1/E' of people v'i tj.l ;)ypertension are detected and
adequately controlled
sho~in:
wi th elcvated blood pressure, only 1
~~equently,
treated.
under treatment,
hi~h
2~
million people
millio~'1
are adequately
that out of
by the time a patient is detected and
blood
pr~ssure
has been at
~ork
ten
years or Dore, deEtructively attackinz the heart and blood
tl-~e
vessels!, pa'lin':
consequences.
vmy :.f'or heart attac}:s, stro'·'e, and other
The results of these statistics leads us to
~'<rp'~rtens ion
as:\: ';:1':y
is :Jot detected more frequently espe-
cially since it is controllable.
~~e
r'1al'Es
J,-~
fact
t~.at
hypertension lS not frequently detected
a f:1aj or leal th challslre ire America today.
inyol-;,re:--;ent of society is
~:"andatory
to overCOTe the
,.'.chich malce detection 2,:>::d control d iffic1)l t.
:Lotal
obstacle~:
A fe'N of
tl~e
obstacles encou11tered are:
1)
;Jiscoverinr~ '~>e :nillions of un:mov'l1 persons ',':it>
~i:h
;?)
blood pressure because they feel fine.
Persons '.,-,it::. elevated blood pressure i:-~nore
referrals from a detection center or clin3,c to a
a)
dootor because:
:Jlooc
pressl.).;~e
of~icoJ
the importance of elevated
vms not conmunicatec1 or understood
a~d/or c)
lac'~
of transportation.
.matio~ abou~ ~yperte~6ion ~y
cl)estiorl~~;
:
risl:s of it?
.-
ans~erin~
the
follo~in:
ertE~s~on
58 a major disease
i~ t~e
United States
j 8
essential
:~:enerall;/
~y~ertpnsion
T~e
body continuously
~unctio~s
l;o::I~l.
hn understandin: 0; the cardiovascular system,
of
S co t;-;.e:Collo'::L'1"
-
~lood
pressure.
illustration of the j;eart.
ic a
'7
-
I
VI
r ulrr. ona:c~-
-,,,) 1 '-....,.~ t
Ventricle
-
for
carbo~,,-
c1 ioxic s.
returDS
-
Las a
t':ic~~E)r y,'a_~l
~JGcause
7ro~
frOiTI
it ;Just be ablE) to eject c'looc
the aorta, blood is
~~e
lar~est
artery
distri~uted
to
i~ t~e ~ocy,
As a result
0:
t~is
~rears
~_.aG
~o
million
~to
less ttan
~allons
o~
blood
2.5 billior beats
-::et,
-
is supplied
.'-., ~'
...)'
the
t~1e
sio~al:y
l!.ali'
but over 100,000
iLlce12
ti~es
a day
(7riedDa~:
and i.all :'lerV2 2.D.::.1 is responsible
~~Ol~
p. 20).
'C:1e
heart's orderly c02tractior.
atyim:: "
-
every
~uscle
receivc;s
110
~ib0~
,.
lr
,
con~rac~s
8tir;~'.)latio~1
.
UDlGOn.
tLc electrical
arld cardiac "ailure e1';81)es.
r'l"..
the body.
~i\ive
factors in'Jolved h')
1.
-
normally deliverc to them.
tl~e
blood flow w:lich play
&
10
-
'10 1 1..:£1(' 0':::' olood in. tLe arteries.
701u:-r:s of ;Jlood ::s .::orced
t~l::'Ol).";~
If
3. c~.ecr'eased.
the arteries, tbe blooe:
-rol Ur.ie of Glood -'-0 reac;; all tissu.es is
~:Gcessary -:0
preve:lt
shoe:.
~;1
ood vi
sco~ijJ,>
.:2100d
said to be very
lG
-1cv:ice
c:.S
}~2.r(l
c irculc~:~ i on.
v-'or:~loac]
.
eventually as the
~eart ~uscle
size increases, so Coes its
GntreateC, this
will
to
prEs~ribe a~ticoa~ula~ts
(~ec;~(;as
or
bloo~
co~peDsatory
t~inner ~edicatjon
e the c-,lood
1.:,
The loss
-
o~
elas-
11
-t~c ~at2r ~it~
~o proble~s
~a~der
to
blood.
~ith
~et
elastic blood vessels and thin blood.
Dater
un~il
eve~tually
no water would pass
~'U thOl.,l:~L
=at
-
rJe~)Qsits
a~e,
De-'j',"" tc l)e laio at an early
~~ looel
cause
.\8 t:i,G1C
::"ass2S, :::'at
ti,ey do not
is
-':;:le
depositio~"l
inc:::'eases a:n total
occlusion occurs.
fro;:~
at1-:.erosclercsis
Cllld
3.r.J;:;e:c~osclerosis,
l<,rpertcJ:1sior:
Jesistanc8 to blood flow.
"'a~iS
oj' ':>e sr;:aller arte:;.,~ies,
arte:cioles, and capil.laries
~eart,
blood vessels,
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Cc-cober 25,
1973, Section 1, p. 12.
Ar11uvraL~a,
Jalv,'ant S., a11,d ot}~,8rs, It~vidence o:f };i,-:her
iol .:aoad Levels in" u':~1an,'ypertc11s i ve
Oral Cantrac epti ve ::sers,
~i'8rtilit;{ and S t srility
~~t:~;ynyle3-;;rac
11
22:,
627-6Jo, ,Ju:-:(>, 1977.
Alder:-[',an, I~ic11ael E., editor, ~~yperter}sion:
The "'urse's [(ole
i'-' Am"D:Jla'~ory Care, :3prl,'l'er I;vblishin c - Co., :;e',~ Yor 1r ,
19?7.
American Cancer 30ciety, ""he:,: a
oman ,3;nol'es, " ;\,:nericar
Can c e r Soc i e t y, I Cl c " 11,~)., 1 S' 75 '
..;~1er.icay~
lIear~t
;\ssocia-t~::2.oJJ,
.:iLlGr=-ca!l
:~9ay·t
;\ssocia":.ion., Iil_c.,
Da=.las, Texat,
~:rohlic'(j, ,~clT:'arc
..--..
",'"
D"
".' • I ) .
to COlitrol it.,"
'Ti"ll :=:lood
,
1971:-,
".'-'_ar~\;rir_t ~\·~.D.,
r'~_=o~.'.,r :01.1 Can. i=c,lp
YO-:"lr ::iCl: '::-lood rTe2sure, " 197 L:.,
=;~o~~el~,
a:1d Dustan, ~,arriet
f1;:~ipertens ion Dr~J[; Trca tlTlent ," 197J,
Pa"e, Irvine
Pa'-~e,
,n.T}'lat
1~.,
~Io1...ll.""
'~=\t~er~Tor~_e
J,.-
•
,
r·-
'"
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t
Sl~OlJlr]
'~(no1:~
~;1)out
Sr:101:i::.C_~:>
al1d
ca,'l 1un,," As so c:ia t ioYl, The iuthor (Available
-1--'1 c'pr""l·
.1,
~'.,~
,:J'~,
v
c,~).
lun," associatior. as a co ~nmT1ni
"Afo, You L i v e
=~eal~~:~
rl.C_,
..A
-,
T,
!:~\TirlS :'~~., l\'~·.i)., ar1d. Dtlsta~LJ ~~arl~ie-c I'"
=,rr.nll,
"1)nr Trea tcent 01' ) . rterial lI:'Ipertens ion," 19::'/~·,
Disease,"
A ..l1 er i
1,'~,.J.,
:)octor :;:ceat
•
Y(1)~
":Sconchiectasis, " 197J,
i:reat11e," 1975.
L"; \
:your
"Clironic Cou:--h," 1973.
"Cicarette Smo';:in,,:," 1975.
CO::'L1an, ?ona, "r:ust
Air?" 197!.:-.
"['v.s·t JJiseascs,
Choose Ect1,\'een Ener.,:"y anc'l Clean
',':8
1 ;76.
If
":':::raphysema," 1973.
"I'lu,
II
197J.
'T,)v·,' ~~ o~c to Love Your :<:ids,"
";:'~'J SElo1~inc
r;an Causs a
1976.
Eealt~1.'/
Lon,:', and ?ulfillin,:':
Life," 1974.
i"Lat YOL' Can Do," 1977.
"S ,;cond-iIand :::;rro1,:,c," 197 L;,.
3teinfield, Jesse
~~>lidencc
TTo'.'!
1976.
liT=: Cu-:sic1e
W,': 0;:11 en
are
~he
lunGs,
T-:ic1;:in~--
II
1975.
the Ci:-=:arette Habit," 1975.
America?} ~',:edical .'\ssociation, "Your Blood Pressure," The :'1.uthor,
I,Io::1roe, ~,;is., 1972.
Apostol ides, Aristide, and otbers, "Fa tient Par<; icipatimi. In
a :>Iypertension Control Fro:-;ram," ,Journal of A:l1erican
~edical Asso~iation, 2J9:1507-1514, April 11~, 1972.
-,
-- +t erman, ..:5evY;Yvepman,
~
t
~ I"'
,"","
--'.-J
~\:mette ,
bau
r.,ary
.\UCE; an d J.'lCZ,
"Eypertensiol1:
Detection, Evaluation, and Trea t:nent, "
~:urs i nL~' Dipest 4: 55- 59, 'Tinter, 1976.
j..
Brams, 'Tilliam AlexancJer, Your Blood Pressure and :.0\,.,' to Live
w~~~ It, J.B. Lippincott Co., Philadelphia, 1956.
:3uckley, ;'~a thleen, ,,:,.Thy }~ypertens i ve Teena:-ers /-\.ccept our
Treatment Program," ':On h:48-51, 1:ay, 1977.
Conte, Xr.drea; Brand zel, :"erle; and :;'hi tehead, Susar;., "::rou,p
"'or 1= '.'Ti tr_ l~ypertensive Patie':1ts, American Journal of
~';Uj::,sin? 74: 910-912, ~'ay, 1971f..
II
del Bueno, Dorot~i~.T ,T., "c:::'he Renal :-=u1'noral ,System: A Cause
:-::ypertensioY'," ::-T 32:109-113, Septe:nber, 1975.
It:;'!';
Didn't :('now Better, So 1:e Did it
October, 1975.
:~ronr:,"
0=
32:32-37,
Lowdall, Sharen ;;'., "Dreati:lin,: 'l'echniques -:;hat Eelp :Reduce
Hypertension," ~l'T L~0:73-76, October, 1977.
Du''':dale, Kat:.. leen, Pi l.~anual of :Corm {'or Theses and "'erm
. :Re~)orts, r::'he Author, Lloominr~ton, In,d., 1972 ( available
at t~'1e Indiana Uni versi ty Bookstore, Bloomin~ton).
A :[anua1 on ;:'ri tin¢': ::1esearch, 'l'he Author, Eloo:niE,c~ton,
Ind., 1967 (available at the Indiana Gniversity
DooY:store, I',loomin"ton).
'Jv.r.bar, Jacc!, ueline, It:;:: erspecti ves on Coronary S is~~- -lart J: I .
ThT?Se :~urse :jpecialists are Char:.c'-inr' the J is1c i icture, "
~s 1:-0:27-32, --'ebruary, 1977.
:8un::1, Laura E.,
"r,Iana'-in;-~
~:ypertension,"
"Fatients
~'.;ay
J
'Ial',~
1 ')7 L;- •
and :',,;otivatin c - the Fatient v,'i th
?iursinrr Update 5:1-13, June, 1974.
About
l~yper
tensior:,"
Nursin;~
Update 5: 3-15,
':::f"::ect' in ~LY1:Ectension," Journal 0: A:nerican
:,:ec:ical ;\ssociation 239: l i-l-D5, April14, 197'E~----
"i~ducation
:7ederspiel, Billie, "Renin and Blood Pressure," American
Journal of Nursin'~ 75:1 LJ-62-1 Li64, September, 1975.
-
:?oster, Sue, and I'ou,sch, Jeborah C. J "rromotinr~ latient
Adherence," ~~merican Journal of iIursin'~~ is: c,29-BJ2,
:::a:r,
1978.
'?riedmal l , l~eyer, and Rosen:11an, ':';lay l~., '::'ype A :2e~lavi or and
Your Eeart, ~,'a'.','cetts 11.1blications, I~c., Creen'Nich,
Conn., 1971,~.
Calton, Lm':rencs, a~d ?innerty,7ran 1c A.,~;le Silent Disease:
:::ypertension, ~:'he ~~e1,\' American Library, Inc., ?'e',v Yor'':" ,
".
1 0"7
/.)
Giblin, Elizabeth, "CoYltrollin,:: liiC;h :t::lood Pressure,"
American JOllrna 1 of I,Tursinf" 7 (3 :S24, ~.~ay, 1972.
Gl uclc, .Joan, "Ey-pertcns ion:
Carin' :£'or tl}e fa ti f:nt v,,:i;o "2ceh.;
,.:,,,,',',1,"
7)'. ~!.'7h-7·C.
~e~)'tem"\e'~
1 0 74
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• u
... _,'" .
1:
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•
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.... ) ' ; . . . . J
./
•
GreenfL'?ld, Diane; Grant, ~(obin j and J-iieberma:i, -:-nl:Ll!.,
"C:lildren Can ~~av'2 =-:L~ll :2100d Pressure Too," AIJerican
T01'rY1~1
o-P
7'(:-"'(70-7'7? ""ay' 10'7(.
ct
_ ;'.Inrsl'n"
. . ' .... ,
_ ....
/(-./e
U
~_,J.
A ..... :. ...
IIa:nilton, 1'.;"
f"~,l.
"i=ypertcms ion," l;urs; n
l'·~aJ~c11 2J,
l-~orosr~a]~,
I'
c
-
,
r.:irro:c 146: 23-25 ,
1976.
Il-'ei18,
O:Iovf
I.)
....
I\T
\..,
f
,39: ,3r-LH ,
r..
;:::;
Jal'lUary, 197(,.
Eun:o.t, J. "'illis, ano others, The Heart,
l\~ e' 'i Yo r k, 1 97 P •
-.
~rc(':rav'-:r~ill
:2oo l . Co.,
Vann'21, "'i11ia;(\ B., and oth'2rs, ""pi demiolo"ic Assessnent of
the '201e of l:lood ?reSSl1re in Stro\~e." Journal 07 Allier; can
;'-'e(~ical ~'issociation, 21!~: JC1-,303, Cctobel~ 12, 1<;70.
Kapla~,
Your Jlood Pressure:
Press, ~ew York, 1?7~.
~orman ~.,
~edcom
Vochar, ~=a110ndra S., "::~ypertension 3creenin{;," Journal oF'
li8erica(l I~edi cal Ass ocia tion 2,36: 2551, :\10vember 29, 1976.
Larach, John :!-:., editor, ~i:vperten.sion I'-lanual,
l'ublisLinC Corp., :1ew Yode, n.d.
Dur~-Dor'n211ey
Lo:::::-ie, Jennifer, "Hypertension in Children. and .Adolescent::3,
Hospital Practice 10:31-92, June, 1975.
lon'~,
It
j','Iadeleine 1., arlo others, "Hypertension: "'hat Patients
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r,~ay, 1976.
Luckmarm, Joan, ard Sorensen, :C:-aren 8reason, ~~edical-3u.rc'ical
nUl'S iner :.'\. fsvchophys iolo,""ical Approach, ,,' .~.
.::: 8.LlnOerS
Co"
1~"ilac1,elp:;.ia, 1 S'7 11·.
;.:alone:/,
~os
e::-nary, "~T c'?lpin- YOl)r Eypertens j'.'e P8 t len ts 1,i ve
['ursin": 72 3:26-35, October, 1971;.
Lon;r~er,"
fressure can
90-91,
.-
~,~erc~T
j
,:;:-:.a:cp; 2.;'1,d Do:,'i~e, ':"1112 =~ypertens ion Handboo'-;- , Division
of :'.:erc 1-;- and Sompany, Inc., ITev: YOy',::, 197'-:-.
:.:iller, =~obe:ct A., Fov' to T,l ve I"i th a r:eart Attack (and i~Q1.·i
to Avoid One), Chilton Boo~ 80., ?adnor, Pe~n., 1971.
I.~i tchell,
'?llen Sullivan, "fro tocol for ':::'eac11inc: l=ypertens i'ie
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ll:~:l, 1977.
:.:oore, :J~ictael A., 'Typertens lon in the Ambula tory Patien":.,"
!.J :":'.:or-lcan"
~
~ar0;1\r
-'-)1--c:lc'a"
,. . ToH"'mb~·'Y'
1077
_"rn,_
")"".1
l,1,(~,,"
J, L 1c.;·r-..1_cP.
,~.'.J
",.,.,
,C1
CJ..,
7,
•
"Eyperter:sion Treated by Salt 2cstriction,"
'Tr~e
1:227-2JO, ?ebruary 4, 1978.
~!:os er,
:~ar'vin, tf~eport 0:: the Joint Na tioYlal COffiF; i ttec on
Detection, J~aluation, and Treatment of ~iCh Plood
Fress1),rtc: A 800perati ve Study," Journal of Arne~'icalj
~ejical Association 237:235-261, Ja~uary 17, 1977.
-.
.....
'.;
Dale, C.:L., "L~
.See," n.d.•
.,
}1.
YOll Srn()~~e--=-:ere's
d.
1-'};at Your Doctor
f·~ay
SLol),ld a Girl Smo',,:e?" 197:,.
~o
"S tar-v in:" for
,.
}ili.~
7ilters Protect?" 197J.
=op~ysema ~ocs
:
to Your
1977.
;:;-teinfeld, Jess e 1., "::;T oke
o.f Sr'2o~·:i~.=,"
c:~,
i:-nals :
~~eal tll
COl1sequ,ences
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=~icora,
jeverl:; ~~en:::,y, ":Yospital Provides })ypertensio:J::;creeninc~
Servic("," i=o:Jpitals 1:-9:91-92, ;::a;y 1,1975.
Ca'kes, I'llocas '., a~1d otr.ers, "Soc:'al -::'actors iE ?~ev:ly
DiscO'lered ~le\'ated =lood PreSS'L:re, " ;~ursinc-: Jir"Cst
':1 • ":l. J'::! - --,'.,
')1:..
Ta'" 'U=->
"'e 1"Y'1)ar'" 1 (1'7
t.-:
ury.'
/ ( r:;
j
-.
•
_!
_1
~""..L
-
~J'
J
•
Cardiovascular IJursin.:'" ,
Co.,
~'.! ei/\~
Yor'1~,
1975·
Pa"e, Irvine :r., "~~:;:'8:r'iO'~lS ::errors in tLe ~.~a:'la~"e;:1er:.-::; 0:;:'
};yperte,'ls ion," Journal 0: American Ced ical Associa± io:'1
2J~:2621-2~2?, December 6, 1976.
'Poo'ol e'"'U -- '.T........."';_;:.,;:'a , r'a-Y'ol'ITl1
"f"',,,,+~
n+ 0 T7'\C'T)er-:-v "'''lC'
ion to Tr11prove
...
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" -"urC'l'l~-" r:;( (.,.')0
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Perloff, ~orothee, editor, The ~~edical Clinics of ;'Torth
Al.lijrica, ','.13. Saunders Co., Eliladelp:1ia, 1977.
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9 C, J un e, 1 977 .
'2ahr:mn, JaInes C., "Hypertension," Ccc1...mational
pp. 17-21, January, 1975.
8.eport
l~ealth
J':;urse,
rat:_onal'~2art, ltc:.,':, and Ilood Institl1te ::2as\:
0-::1 Flood i::cessiJ.re ;::;on t:col in Child::cen, ":;::;18 ~;e"in­
l-:_L:'"'-~:~s 0-:: ~=YI)erte~1s iO'~1 ," ~=rneJ2~-!.cy· ~:~ edic.irle 9:)1 5-110,
11>12J, Jul=', 1977.
1)['
~c>e
'o:_~cc
-
?ooertson, 'Ja'vid, aml others, "':':ftects 0: Ca.ffeine on Plas-sa
2en i~-! Acti vi ~~y, :ja:.::ec:101amines, and Blood [ress ure, "
Tl"JC! ;:;e-,/ '?n~'land ,Jou'~~~al of l;~edicine 29S:1r:l-1':'j,
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in""''''''
<-Tanuary GO,
>' ('_"
I": 0"':J ins en , ). . lice :".,
":8etectio:" and Control of :;iypertensior::
;;l,allen.'-e to all n1.lrses," LCl.merican Journal of !;ursini':
7():77?'-720, I,i8..:;r, 1)7<.
"3al t I ir'd, t
:~ eeded
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to
r2:'e'.ren~
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S cl,racie:c, :Slinor :;., editor, "l1SSe2SIT.ent P inpoin ts Lyperte:."~SlOYl CallS(;S," [iC:=1Ii 2;·:101C, I.~aYt 197'5.
"=: L; -:; enin' s
197(.
~~ole
in ==ypertension,"
":C:lac'r's ;Cid'ley :::3ystem a
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LYo, ~.~ay t 1r:
/ (( •
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),o::-::.~:
~;ypertensicn
23: 672,
Thrcc.t,"
f\
~:arch,
r-..,.-., .... T
,'il)lU,
3 earle ]~aborator;:;r, ":;ndcrstand in' ~=i?:'l Blood I'ressure," Searle
and Co., San Juan, fuerto Rico, 1976.
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l:~J.·}'sirc ResearcY27: 30- 35, January- '?ebruary, 1972.
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C on.trac t irl r-,. "V'c~ i:tr:
ra~ien':s to lITi}x'ove (3or.1IJliarce," Eospitals 51: 21-C2, :=L,
tf
Decem~er
1, 1977.
Ste1,'.raY't" "illiam l:·., ,,~ryperten8ion and l=ypc;rtensive :;cart
Di~,ea3e in Ae1ults," t
ria tional CenteY' for :r~eal th
Statistics--"i tal and Eeal th3 tats 1: 8-1 (), ;,:ay, 1966.
T
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"3tudy Absolves Coffee Drin:::irl:~~,
Fovem2cr 29, 1978, p. j.
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11
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'i.':r.e I,~uncie Star (Indiana)
El
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tile 80ronary Care Unit,
~,~ G\\' YO]:>=,
1976.
::'oi:;ian, I.:olds, "Eypertc1l2io~1. and Obesity," new .sn.;land
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2:leanor "2.lters, and '!'reece, James '."Iilliam, ::::leiI1ents
in Nursin~, C.v. ~osby Co., St. Louis, 1973.
or
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Studen'~' s"t~ide for ',."ri tin rc Colle~'8
CjrJ.ica:·""'~() PY'88S, C~·:ica::~'.'o J 1976.
Papers,
tJ.S. ""epartme::'lt of :TealtL, '"::duc8.tion, and '."elfare, '?llC
;:~utl-:.or,
rrlJrabian,
lJo,
=_\..rer8i-t~;-
~ei:hesdaJ
"i:=. 'h
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r~d.
''''acts a.nd ?ictioll,"
:l3loocl Pressure:
11.
d.
're 3lac::, ~=ere are Some?acts You Should
About :=i,r'll Jlood Press1..l.re," n. e1.•
~rou
Ind:'~L,
':21-;.eoo.ore,
"-'atc;-
you::.~ l~looCl
Pressu.ce!" 1976.
"Y':atioYlal ~:"i.::h :21000. Pressure Education Pro::ram:
S }'l e e -t ,II 11. c1 •
"I·T1..1rf3 in'""
:Sduca tion
J.:1
:(11.0'.'/
Fact
IIi)'. flood Pressure Control," n. d .
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