Hypertension
A Case Study
Jennifer Kitchen
July 19, 2013
• 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
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•
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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
• 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?
• Normal BP is about 120/80
• Systolic pressure- pumping pressure
• Diastolic pressure- resting pressure
•
(ACP, 2004).
Normal Blood Pressure
What is Hypertension?
Table 1: Stages of hypertension
Stage
Optimal
Normal
High-normal
HTN stage 1
HTN stage 2
HTN stage 3
Systolic
<120
120–129
130–139
140–159
160–179
>180
Diastolic
<80
80–84
85–89
90–99
100–109
>110
Systolic and diastolic pressures given in mm Hg.
(Foex, 2004)
Stages of Hypertension
What is Hypertension?
• 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
• 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
• Living with HTN…
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•
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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
• 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
Sometimes all we need is to take a
break on the busy tracks of life.
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