According to the 2011 American College
of Cardiology Foundation (ACCF) and the American Heart Association (AHA), 72
million Americans have high blood pressure (Bertoia, Waring, Gupta, Roberts,
and Eaton, 2012). When looking at blood pressure readings, the top number
(systolic) measures the pressure in the arteries when the heart beats (or as
the blood pressure cuff is squeezing your arm); and the bottom number
(diastolic) measures the pressure in the arteries between heartbeats (or as the
pressure on your arm is being released) (AHA, 2014).
AHA (2014) categorizes blood pressure as follows:
Common Signs and Symptoms of High Blood Pressure:
- Chest pains
- Shortness of breath
- Blurred vision
- Nausea and/or Vomiting
- Headaches
Complications of Uncontrolled High Blood Pressure:
- Heart Attack (Myocardial Infarction/MI)
- Stroke (Cerebrovascular Accident/CVA)
- Aneurysm-weakened or bulging walls of any blood vessels, most commonly in the brain, heart, or stomach.
- Kidney disease-can cause kidney failure that requires dialysis.
Warren
(2014) reports that most guidelines indicate that in addition to medication,
people with high blood pressure should be given lifestyle advice.
Some Recommendations for Lifestyle Changes:
- Take all medications as prescribed by the health care provider. All medications work differently and can help control your blood pressure in different ways.
- Decrease sodium and salt in your diet. This includes soy sauce, seasoning salt, canned soups, processed foods, and hot sauce.
- Increase daily water intake to 48-64 oz every day. That is three to four 16 oz bottled waters or six to eight 8 oz cups of water.
- Keep a healthy weight by making healthier food choices (increasing fruits, vegetables, and whole grains; decreasing fried foods, fast foods, junk foods, and greasy foods), and exercise at least 20 minutes every other day.
- Never miss doses of medications by waiting until your prescription runs out before you go see your provider.
- Stop or never start smoking cigarettes.
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Real Life Summary of Hypertension:
Imagine turning on a water hose and there is a kink in the
line so the water is only dripping out. The pressure continues to build and
this may cause other holes in the line, but if you remove the kink, the water
can flow easier with less pressure.
References
American Heart Association. (2014). Understanding your blood pressure readings. Retrieved www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Articel.jsp
Bertoia, M. L., Waring, M. E., Gupta, P. S., Roberts, M. B.,
& Eaton, C. B. (2012). Implications of new
hypertension guidelines in the United
States. Hypertension,
60(3), 639-644. http//dx.doi.org/10.1161/HYPERTENSIONAHA.112.193714
Chu, V. B., Seshariri, M.,
Serpas, S., Shaheen, C. M., & Cardenas, A. (2007). Five major effects of high blood pressure-3D medical animation [Video]. Retrieved from https://m.youtube.com/watch?v=ICLHbwBBvFc
Warren, E. (2014). Hypertension: Why we measure it, why we
treat it. Practice Nurse, 44(12), 14-19.
Nice analogy!
ReplyDeleteThank you Nikeyia, I tried to think of something relatable to everyone, I am glad you understood it!
DeleteKeisha,
ReplyDeleteI thought you might like to see some of the work from Chris Hebert. He has published some interesting point of service workflows for valid HTN values.
Hebert, C., Shidham, G., & Hebert, L. (n.d.). Should the target for blood pressure control specify both a systolic and a diastolic component? Current Hypertension Reports, 360-362
Hi Rhonda,
DeleteThank you for the reference regarding hypertension. It appears Chris Hebert’s article is aligned with the recommendations by the Seventh Joint National Committee (JNC7), which is one of the leading organizations for hypertension diagnosis, assessment, and treatment management. Research by Anusuya, Raghuveer, Akkhil, and Surbhi (2013) indicate JNC7 guidelines since as early as 2003 have been a normal blood pressure of <120’s/<80’s and each increment of 20/10 mmHg doubles the risk of cardiovascular disease starting at 115/75 mmHg. As a practicing clinician with an extensive history in Nephrology, I am aggressive when treating hypertension with the hope of preventing co-morbidities. I am mindful when treating the elderly and any patient with existing co-morbidities, but preventing a myocardial infarction, aneurysm, or end stage renal disease is a top priority and often guides my decision process.
Thanks,
Kiesha
Reference:
Anusuya, G., Raghuveer, C., Akkhil, C., & Surbhi, R. (2013). Management of hypertension: Focus on current treatment algorithms. National Journal of Integrated Research in Medicine, 4(3), 133-137.
Dental hygienists routinely perform blood pressure and vital signs at each dental hygiene treatment appointment. Dental hygiene treatment should not be provided for a patient with a medical risk greater than an American Society of Anesthesiologists (ASA) III classification (Darby & Walsh, 2014).
DeleteReferences:
Darby, M. and Walsh, M. (2014). Dental hygiene theory and practice (4th ed.). St.Louis, MO: Saunders.
Hi Wanda,
DeleteThank you for contributing to my blog. I agree vitals should be done at dental visits, especially with extractions and major procedures. However since becoming a PA-C eight years ago, I can count on one hand how many patients required approval for dental procedures due to elevated blood pressure. Personally, my blood pressure has never been taken at my dental office. I strongly believe, any interaction with a health professional is a great opportunity for health promotion and education. Dental health is an important tool that can be utilized for continuity of care and health assessment.
Kiesha
OMG!! This is important, yet scary information. I love the taste of salty food however I try to be cognizant of this information and its importance. Especially since it has a strong cultural impact on the African-American community. I have recently taken seasoned salt out of my diet when cooking at home, so that is a start!!
DeleteAlishia,
DeleteThank you for your post. High blood pressure is a very scary topic and often overlooked because there are initially no warning symptoms for diagnosis. Sodium is one component of control, but daily intake of 48-64 oz of water will often balance sodium content in the bloodstream. “Soul food” is definitely strong in the African American community; however, we must understand healthier food choices do not mean “no flavor,” it just means altered cooking methods for better health.
Kiesha
With hypertension being the leading cause of cardiovascular morbidity and mortality in African Americans, your blog is timely, and important! I feel that in order for any healthcare initiative to work, patients need to trust the person presenting the information. Without that trust, patient compliance will be low. In my experience, this has been the case, particularly among my African American patients. Curfee et al., (2013) evaluated medication compliance for hypertensive inner city African Americans. The author’s findings suggest that medication compliance was facilitated by trust in the physicians. Your simple yet very informative blog will go a long way in establishing that trust in all populations.
ReplyDeleteExcellent job!!
David Alexander
Reference:
Cuffee, Y. L., Hargraves, J. L., Rosal, M., Briesacher, B. A., Schoenthaler, A., Person, S., & ... Allison, J. (2013). Reported racial discrimination, trust in physicians, and medication adherence among inner city African Americans with hypertension. American Journal Of Public Health, 103(11), e55-e62.
Hi David,
DeleteThank you for contributing to the discussion. I agree that trust contributes to patient compliance, which is why I always try to build a firm patient-provider relationship. I have had significant success with positive outcomes by continuing to build trust with patients and including family members or parents in the treatment plan. Compliance can be very difficult with my patient population, but I will continue to practice in their best interest.
Best wishes,
Kiesha