HypertensionA Case Study

Jennifer KitchenJuly 19, 2013

Overview

• Vicki, a patient just diagnosed with Hypertension (HTN)• What is Hypertension?• Appropriate Treatment Prognosis (including therapies,

medications, etc.) • Patient Teaching• Potential Barriers to Therapy

Vicki

• 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

What is Hypertension?

• 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)

Normal Blood PressureWhat is Hypertension?

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

Stages of Hypertension What is Hypertension?

(Foex, 2004)

Table 1: Stages of hypertension

Stage Systolic DiastolicOptimal <120 <80Normal 120–129 80–84High-normal 130–139 85–89HTN stage 1 140–159 90–99HTN stage 2 160–179 100–109HTN stage 3 >180 >110

Systolic and diastolic pressures given in mm Hg.

Treatment Prognosis

• 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)

Patient Teaching

• 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…• 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)

Potential Barriers

• 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.”

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

References

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.