Upload
vuhanh
View
216
Download
1
Embed Size (px)
Citation preview
UNDERSTANDING HYPERTENSION
THE ROLE CHWS AND INSTRUCTORS CAN PLAY IN HYPERTENSION WELLNESS AND PREVENTION
Presented by:
Texas AHEC East Coastal Region
CHW Training Organization Approved by the Texas
Department of State Health Services This project is funded in part by “State Public Health Actions to Prevent and Control Diabetes, Heart
Disease, Obesity and Associated Risk Factors and Promote School Health,”
CDC-RFA-DP13-1305, Centers for Disease Control and Prevention, U.S. Department of Health and
Human Services, through Texas Department of State Health Services.
LEARNING OBJECTIVES (CHWS)
1. WHAT IS HYPERTENSION AND HOW IS IT DETERMINED?
2. WHAT ARE THE CAUSES AND RISK FACTORS FOR
HYPERTENSION?
3. WHAT ARE THE CONSEQUENCES OF NOT TREATING
HYPERTENSION?
4. HOW CAN HYPERTENSION BE TREATED OR
PREVENTED?
TEACHING OBJECTIVES (INSTRUCTORS)
• TEACH CHWS TO DEVELOP OBJECTIVES WHEN PRESENTING
HYPERTENSION IN THEIR COMMUNITIES.
• TEACH CHWS TERMINOLOGY AND BLOOD PRESSURE READING
STEPS THAT EMPHASIZE A MORE THOROUGH KNOWLEDGE
BASE AND A HANDS-ON APPROACH.
• CONDUCT HYPERTENSION RESEARCH AND TEACH CHWS TO
IMPLEMENT HYPERTENSION ACTIVITIES WITH ADVOCACY
AND CULTURAL COMPETENCY COMPONENTS IN THEIR OWN
COMMUNITY.
• DEMONSTRATE STRESS-RELIEVING EXERCISES CHWS CAN TAKE
BACK AND SHARE IN THEIR COMMUNITIES.
• PROVIDE CHWS WITH EFFECTIVE TEACHING TECHNIQUES FOR
HYPERTENSION EDUCATION.
HYPERTENSION SELF-ASSESSMENT
1. WHICH OF THE FOLLOWING AFFECTS BLOOD PRESSURE?
a) HOW HARD THE HEART PUMPS
b) HOW NARROW OR WIDE THE BLOOD VESSELS ARE
c) BLOOD VOLUME
d) ALL OF THE ABOVE
2. WHERE IS THE BLOOD PRESSURE HIGHEST?
a) ARTERIES
b) CAPILLARIES
c) VEINS
HYPERTENSION SELF-ASSESSMENT
3. WHAT IS THE SYSTOLIC BLOOD PRESSURE?
a) ARTERIAL BLOOD PRESSURE WHEN THE HEART IS ACTIVELY PUMPING BLOOD
b) ARTERIAL BLOOD PRESSURE WHEN THE HEART IS IN BETWEEN BEATS
c) AVERAGE SUSTAINED CAPILLARY BLOOD PRESSURE OVER ONE MINUTE
d) AVERAGE BLOOD PRESSURE WITHIN THE BRAIN
4. WHAT CATEGORY DOES THE BLOOD PRESSURE 145/82 FALL IN?
a) NORMAL
b) PREHYPERTENSION
c) STAGE 1 HYPERTENSION
d) STAGE 2 HYPERTENSION
HYPERTENSION SELF-ASSESSMENT
5. WHICH OF THE FOLLOWING IS NOT A RISK FACTOR FOR ESSENTIAL HYPERTENSION?
A. FAMILY HISTORY OF HYPERTENSION
B. OBESITY
C. CIGARETTE SMOKING
D. EXCESSIVE ALCOHOL USE
E. PHYSICAL INACTIVITY
F. DEHYDRATION
SELF ASSESSMENT ANSWERS
1. D- ALL OF THE ABOVE
2. A- ARTERIES
3. A- ARTERIAL BLOOD PRESSURE WHEN THE HEART IS ACTIVELY
PUMPING BLOOD
4. C- STAGE 1 HYPERTENSION
5. F- DEHYDRATION
WHAT IS HIGH BLOOD PRESSURE?
• BLOOD PRESSURE IS THE FORCE OF BLOOD PUSHING AGAINST THE WALLS
OF THE ARTERIES AS THE HEART PUMPS BLOOD. IF THIS PRESSURE RISES
AND STAYS HIGH OVER TIME IT CAN DAMAGE THE BODY IN MANY WAYS.
• BLOOD PRESSURE IS MEASURED AS SYSTOLIC AND DIASTOLIC PRESSURES.
• "SYSTOLIC" REFERS TO BLOOD PRESSURE WHEN THE HEART BEATS WHILE
PUMPING BLOOD.
• "DIASTOLIC" REFERS TO BLOOD PRESSURE WHEN THE HEART IS AT REST
BETWEEN BEATS.
• YOU MOST OFTEN WILL SEE BLOOD PRESSURE NUMBERS WRITTEN WITH THE
SYSTOLIC NUMBER ABOVE OR BEFORE THE DIASTOLIC NUMBER, SUCH AS
120/80 MMHG. (THE MMHG IS MILLIMETERS OF MERCURY—THE UNITS USED
TO MEASURE BLOOD PRESSURE.)
OTHER NAMES FOR HBP
• HYPERTENSION
• WHEN HBP HAS NO KNOWN CAUSE, IT MIGHT BE CALLED ESSENTIAL
HYPERTENSION, PRIMARY HYPERTENSION, OR IDIOPATHIC
HYPERTENSION.
• WHEN ANOTHER CONDITION CAUSES HBP, IT'S SOMETIMES CALLED
SECONDARY HYPERTENSION.
• ISOLATED SYSTOLIC HYPERTENSION (ISH) IS WHEN ONLY THE
SYSTOLIC PRESSURE IS HIGH
• MANY OLDER ADULTS HAVE THIS CONDITION. ISH CAN CAUSE AS MUCH
HARM AS HBP IN WHICH BOTH NUMBERS ARE TOO HIGH
CATEGORIES FOR BLOOD PRESSURE IN ADULTS
Category Systolic
(top number)
Diastolic
(bottom number)
Normal Less than 120 And Less than 80
Prehypertension 120-139 Or 80-89
High blood pressure
Stage 1 140-159 Or 90-99
Stage2 160 or higher Or 100 or higher
The table below shows normal blood pressure ranges for adults. It also shows
which numbers put you at greater risk for health problems.
HYPERTENSION BASICS
• BLOOD PRESSURE DOESN'T STAY THE SAME ALL THE TIME. IT LOWERS AS YOU
SLEEP AND RISES WHEN YOU WAKE UP. BLOOD PRESSURE ALSO RISES WHEN
YOU'RE EXCITED, NERVOUS, OR ACTIVE AND TENDS TO RISE WITH AGE.
• IF YOUR NUMBERS STAY ABOVE NORMAL MOST OF THE TIME, YOU'RE AT RISK FOR
HEALTH PROBLEMS.
• IF YOU'RE BEING TREATED FOR HBP AND HAVE REPEAT READINGS IN THE NORMAL
RANGE, YOUR BLOOD PRESSURE IS UNDER CONTROL. HOWEVER, YOU STILL HAVE
THE CONDITION.
• YOUR SYSTOLIC AND DIASTOLIC NUMBERS MAY NOT BE IN THE SAME BLOOD
PRESSURE CATEGORY. THE MORE SEVERE CATEGORY IS THE ONE YOU'RE IN. FOR
EXAMPLE, IF YOUR SYSTOLIC NUMBER IS 160 AND YOUR DIASTOLIC NUMBER IS
80, YOU HAVE STAGE 2 HBP. IF YOUR SYSTOLIC NUMBER IS 120 AND YOUR
DIASTOLIC NUMBER IS 95, YOU HAVE STAGE 1 HBP.
LEARNING ACTIVITY (CHWS)
TERMINOLOGY (INSTRUCTORS)
• SPHYGMOMANOMETER: AN INSTRUMENT FOR MEASURING
BLOOD PRESSURE, TYPICALLY CONSISTING OF AN INFLATABLE RUBBER
CUFF THAT IS APPLIED TO THE ARM AND CONNECTED TO A COLUMN
OF MERCURY NEXT TO A GRADUATED SCALE, ENABLING THE
DETERMINATION OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE BY
INCREASING AND GRADUALLY RELEASING THE PRESSURE IN THE CUFF.
• KOROTKOFF SOUNDS: ARTERIAL SOUNDS HEARD THROUGH A
STETHOSCOPE APPLIED TO THE BRACHIAL ARTERY DISTAL TO THE CUFF
OF A SPHYGMOMANOMETER THAT CHANGE WITH VARYING CUFF
PRESSURE AND THAT ARE USED TO DETERMINE SYSTOLIC AND
DIASTOLIC BLOOD PRESSURE.
LEARNING ACTIVITY (INSTRUCTORS)
SYMPTOMS AND MYTHS OF HYPERTENSION
• ONE OF THE MOST DANGEROUS ASPECTS OF HYPERTENSION IS THAT IT
IS ASYMPTOMATIC. MEANING PEOPLE MAY NOT KNOW THAT THEY HAVE
IT.
• NEARLY ONE-THIRD OF PEOPLE WHO HAVE HIGH BLOOD PRESSURE
DON'T KNOW IT.
• BE AWARE OF COMMON SYMPTOMATIC MYTHS OR MISCONCEPTIONS.
THEY INCLUDE:
• HEADACHES
• NOSEBLEEDS
• BLOOD SPOTS IN THE EYE
• FACIAL FLUSHING
• DIZZINESS
CAUSE VS RISK FACTOR
• WHEN TALKING TO CLIENTS IT’S IMPORTANT TO BE ABLE
TO EXPLAIN THE DIFFERENCE BETWEEN CAUSE AND RISK
FACTOR.
• CAUSE IS DEFINED AS A CAUSE THAT DIRECTLY OR WITH
NO INTERVENING AGENCY PRODUCES AN EFFECT.
EXAMPLE, HIV IS THE CAUSE, AIDS IS THE EFFECT;
• RISK FACTOR IS DEFINED AS SOMETHING THAT INCREASES
YOUR CHANCES OF GETTING A DISEASE. SOMETIMES,
THIS RISK COMES FROM SOMETHING YOU DO.
CAUSES OF HYPERTENSION
PRIMARY (ESSENTIAL) HYPERTENSION
FOR MOST ADULTS, THERE'S NO IDENTIFIABLE CAUSE OF HIGH
BLOOD PRESSURE. THIS TYPE OF HIGH BLOOD PRESSURE,
CALLED ESSENTIAL HYPERTENSION OR PRIMARY HYPERTENSION,
TENDS TO DEVELOP GRADUALLY OVER MANY YEARS.
CAUSES OF HYPERTENSION
SECONDARY HYPERTENSION
SOME PEOPLE HAVE HIGH BLOOD PRESSURE CAUSED BY AN UNDERLYING
CONDITION. THIS TYPE OF HIGH BLOOD PRESSURE, CALLED SECONDARY
HYPERTENSION, TENDS TO APPEAR SUDDENLY AND CAUSE HIGHER
BLOOD PRESSURE THAN DOES PRIMARY HYPERTENSION. VARIOUS
CONDITIONS AND MEDICATIONS CAN LEAD TO SECONDARY
HYPERTENSION, INCLUDING:
• KIDNEY PROBLEMS
• ADRENAL GLAND TUMORS
• CERTAIN DEFECTS IN BLOOD VESSELS YOU'RE BORN WITH (CONGENITAL)
• CERTAIN MEDICATIONS, SUCH AS BIRTH CONTROL PILLS, COLD REMEDIES,
DECONGESTANTS, OVER-THE-COUNTER PAIN RELIEVERS AND SOME
PRESCRIPTION DRUGS
• ILLEGAL DRUGS, SUCH AS COCAINE AND AMPHETAMINES
CONTROLLABLE RISK FACTORS
• OVERWEIGHT / OBESITY
• NOT BEING PHYSICALLY
ACTIVE.
• USING TOBACCO
• TOO MUCH SALT
(SODIUM) IN YOUR DIET
• TOO LITTLE POTASSIUM IN
YOUR DIET
• EXCESSIVE USE OF
ALCOHOL
• STRESS
RISKS THAT CANNOT BE CONTROLLED
• AGE. THE RISK OF HIGH BLOOD PRESSURE INCREASES AS YOU AGE.
THROUGH EARLY MIDDLE AGE, HIGH BLOOD PRESSURE IS MORE
COMMON IN MEN. WOMEN ARE MORE LIKELY TO DEVELOP HIGH BLOOD
PRESSURE AFTER MENOPAUSE.
• RACE. HIGH BLOOD PRESSURE IS PARTICULARLY COMMON AMONG
AFRICAN-AMERICANS, OFTEN DEVELOPING AT AN EARLIER AGE THAN IT
DOES IN OTHER RACES. SERIOUS COMPLICATIONS, SUCH AS STROKE AND
HEART ATTACK, ALSO ARE MORE COMMON AMONG AFRICAN-
AMERICANS.
• FAMILY HISTORY. HIGH BLOOD PRESSURE TENDS TO RUN IN FAMILIES.
• CERTAIN CHRONIC CONDITIONS. CERTAIN CHRONIC CONDITIONS ALSO
MAY INCREASE YOUR RISK OF HIGH BLOOD PRESSURE, INCLUDING HIGH
CHOLESTEROL, DIABETES, KIDNEY DISEASE AND SLEEP APNEA.
IMPROVING CULTURAL COMPETENCY USING HYPERTENSION TEACHING (INSTRUCTORS)
• HAVE STUDENTS RESEARCH HYPERTENSION TRENDS IN THEIR
LOCAL COMMUNITY (ONLINE, LOCAL HEALTH DEPARTMENTS, ETC).
HAVE THEM FIND ANSWERS TO THE FOLLOWING QUESTIONS:
• ARE THERE DIFFERENCES IN HYPERTENSION RATES AMONG
GEOGRAPHICAL AREAS IN THEIR COMMUNITY?
• ARE THERE DIFFERENCES IN HYPERTENSION RATES ALONG
ETHNIC, RACIAL, OR CULTURAL LINES IN THEIR COMMUNITY?
• WHAT KIND OF ACCESS TO SCREENINGS, PREVENTION
PROGRAMS, AND TREATMENTS DO MEMBERS OF THE
COMMUNITY HAVE? IS ACCESS EASIER OR MORE DIFFICULT
FOR CERTAIN POPULATIONS IN THEIR COMMUNITY?
TREATMENT GOALS (AS DETERMINED BY YOUR DOCTOR)
• YOUR BLOOD PRESSURE TREATMENT GOAL DEPENDS ON HOW
HEALTHY YOU ARE.
• BLOOD PRESSURE TREATMENT GOALS 140/90 MM HG OR LOWER IF
YOU ARE A HEALTHY ADULT
• 130/80 MM HG OR LOWER IF YOU HAVE CHRONIC KIDNEY DISEASE,
DIABETES OR CORONARY ARTERY DISEASE OR ARE AT HIGH RISK OF
CORONARY ARTERY DISEASE
• 120/80 MM HG OR LOWER IF YOUR HEART ISN'T PUMPING AS WELL
AS IT SHOULD (LEFT VENTRICULAR DYSFUNCTION OR HEART FAILURE) OR
YOU HAVE SEVERE CHRONIC KIDNEY DISEASE
TREATMENT
• HIGH BLOOD PRESSURE (HBP) IS TREATED WITH LIFESTYLE
CHANGES AND MEDICINES.
• MOST PEOPLE WHO HAVE HBP WILL NEED LIFELONG
TREATMENT. STICKING TO A TREATMENT PLAN IS
IMPORTANT.
LIFESTYLE CHANGES
• HEALTHY LIFESTYLE HABITS CAN HELP YOU CONTROL HBP.
THESE HABITS INCLUDE:
• FOLLOWING A HEALTHY DIET
• BEING PHYSICALLY ACTIVE
• MAINTAINING A HEALTHY WEIGHT
• QUITTING SMOKING
• MANAGING YOUR STRESS AND LEARNING TO COPE WITH
STRESS
DIETARY APPROACHES TO STOP HYPERTENSION (DASH) EATING PLAN
• SCIENTISTS SUPPORTED BY THE NATIONAL HEART, LUNG, AND BLOOD
INSTITUTE (NHLBI) CONDUCTED TWO KEY STUDIES. THEIR FINDINGS
SHOWED THAT BLOOD PRESSURES WERE REDUCED WITH AN EATING PLAN
THAT IS:
• LOW IN SATURATED FAT, CHOLESTEROL, AND TOTAL FAT
• EMPHASIZES FRUITS, VEGETABLES, AND FAT-FREE OR LOW-FAT MILK AND MILK
PRODUCTS.
• INCLUDES WHOLE GRAIN PRODUCTS, FISH, POULTRY, AND NUTS.
• IT IS REDUCED IN LEAN RED MEAT, SWEETS, ADDED SUGARS, AND SUGAR-
CONTAINING BEVERAGES
• RICH IN POTASSIUM MAGNESIUM, AND CALCIUM, AS WELL AS PROTEIN AND
FIBER.
PHYSICAL ACTIVITY
• ROUTINE PHYSICAL ACTIVITY CAN LOWER HBP AND REDUCE THE RISK FOR
OTHER HEALTH PROBLEMS.
• PEOPLE GAIN HEALTH BENEFITS FROM AS LITTLE AS 60 MINUTES OF
MODERATE-INTENSITY AEROBIC ACTIVITY PER WEEK.
• THE MORE ACTIVE, THE MORE BENEFIT.
• ALWAYS ADVISE CLIENTS TO TALK WITH THEIR DOCTOR BEFORE STARTING
A NEW EXERCISE PLAN.
• QUESTIONS TO ASK MIGHT INCLUDE:
• HOW MUCH AND WHAT KINDS OF PHYSICAL ACTIVITY ARE SAFE?
• ARE THERE ANY RESTRICTION DUE TO MY PAST HEART DIAGNOSIS?
HEALTHY WEIGHT
• LOSING EVEN 5 POUNDS (2.3 KILOGRAMS) CAN LOWER
YOUR BLOOD PRESSURE.
• ONE POUND EQUALS 3,500 CALORIES. SO, TO LOSE 1
POUND A WEEK, YOU NEED TO EAT 500 CALORIES A DAY
LESS OR BURN 500 CALORIES A DAY MORE THAN YOU
USUALLY DO.
BMI CHART
SMOKING CESSATION
• PEOPLE WHO SMOKE ARE UP TO SIX TIMES MORE LIKELY TO
SUFFER A HEART ATTACK THAN NONSMOKERS, AND THE RISK
INCREASES WITH THE NUMBER OF CIGARETTES SMOKED EACH
DAY.
• SMOKERS ARE LIKELY TO SUFFER A HEART ATTACK OR OTHER
MAJOR HEART PROBLEM AT LEAST 10 YEARS SOONER THAN
NONSMOKERS.
• TOBACCO INJURES BLOOD VESSEL WALLS AND SPEEDS UP
THE PROCESS OF HARDENING OF THE ARTERIES.
STRESS MANAGEMENT
THE BODY’S STRESS RESPONSE
• STRESS IS A RISK FACTOR
• WHEN YOU PERCEIVE A THREAT, YOUR NERVOUS SYSTEM RESPONDS BY
RELEASING A FLOOD OF STRESS HORMONES, INCLUDING ADRENALINE
AND CORTISOL. THESE HORMONES ROUSE THE BODY FOR EMERGENCY
ACTION.
• YOUR HEART POUNDS FASTER, MUSCLES TIGHTEN, BLOOD PRESSURE RISES,
BREATH QUICKENS, AND YOUR SENSES BECOME SHARPER. THESE PHYSICAL
CHANGES INCREASE YOUR STRENGTH AND STAMINA, SPEED YOUR
REACTION TIME, AND ENHANCE YOUR FOCUS – PREPARING YOU TO
EITHER FIGHT OR FLEE FROM THE DANGER AT HAND.
SIGNS OF STRESS
• IRRITABILITY - FRUSTRATION
• OVERREACTING TO MINOR DISTURBANCES
• LOSING YOUR TEMPER MORE FREQUENTLY
• FEELING JUMPY OR EXHAUSTED ALL THE TIME
• DIFFICULTY CONCENTRATING OR FOCUSING
• WORRYING ABOUT INSIGNIFICANT THINGS
STRESS SELF-ASSESSMENT: THE HOLMES-RAHE LIFE STRESS INVENTORY
HOLMES-RAHE LIFE STRESS INVENTORY
• 150 POINTS OR LESS – LOW SUSCEPTIBILITY TO STRESS-
RELATED HEALTH PROBLEMS
• 150-300 POINTS – IMPLIES ABOUT A 50% CHANCE TO
DEVELOP STRESS-RELATED HEALTH PROBLEMS IN THE NEXT
TWO YEARS
• 300+ POINTS – RAISES THE CHANCE TO ABOUT 80%,
ACCORDING TO THE HOLMES-RAHE PREDICTION MODEL
UNHEALTHY WAYS TO DEAL WITH STRESS
• SMOKING
• DRINKING TOO MUCH
• OVEREATING OR UNDEREATING
• ZONING OUT FOR HOURS IN FRONT OF THE TV OR COMPUTER
• WITHDRAWING FROM FRIENDS, FAMILY, AND ACTIVITIES
• USING PILLS OR DRUGS TO RELAX
• SLEEPING TOO MUCH
• PROCRASTINATING
• FILLING UP EVERY MINUTE OF THE DAY TO AVOID FACING PROBLEMS
• TAKING OUT YOUR STRESS ON OTHERS (LASHING OUT, ANGRY
OUTBURSTS, PHYSICAL VIOLENCE)
STRESS MANAGEMENT STRATEGY # 1
• AVOID THE STRESSOR
• SAY NO WHEN YOUR PLATE IS FULL
• AVOID PEOPLE WHO STRESS YOU OUT
• AVOID HOT-TOPIC ISSUES
• PARE DOWN YOUR TO-DO LIST
• CONTROL YOUR ENVIRONMENT
STRESS MANAGEMENT STRATEGY #2
• ALTER THE SITUATION
• PLAN AHEAD SO YOU DON’T OVEREXTEND
YOURSELF.
• EXPRESS YOUR FEELINGS RATHER THAN BOTTLE THEM
UP.
• BE MORE ASSERTIVE ABOUT YOUR TIME.
STRESS MANAGEMENT STRATEGY #3
• ADAPT TO THE STRESSOR
• LEARN TO ENJOY TRAFFIC JAMS
• LOOK AT THE BIG PICTURE
• ADJUST YOUR STANDARDS
• REFLECT ON THE POSITIVE THINGS IN YOUR LIFE
STRESS MANAGEMENT STRATEGY #4
• ACCEPT THE THINGS YOU CANNOT CHANGE
• DON’T TRY TO CONTROL THE UNCONTROLLABLE
• LOOK FOR THE UPSIDE
• LEARN TO FORGIVE
• SHARE YOUR FEELINGS
STRESS MANAGEMENT #5
MAKE TIME FOR FUN AND RELAXATION!
• GO FOR A WALK.
• SPEND TIME IN NATURE.
• CALL A GOOD FRIEND.
• SWEAT OUT TENSION WITH A
GOOD WORKOUT.
• WRITE IN YOUR JOURNAL.
• TAKE A LONG BATH.
• LIGHT SCENTED CANDLES.
• SAVOR A WARM CUP OF COFFEE
OR TEA.
• PLAY WITH A PET.
• WORK IN YOUR GARDEN.
• GET A MASSAGE.
• CURL UP WITH A GOOD BOOK.
• LISTEN TO MUSIC.
• WATCH A COMEDY.
PRACTICE WHAT YOU PREACH!
(INSTRUCTORS)
RESERVE SOME CLASS TIME TO DO SOME STRESS-
RELIEVING EXERCISES:
• GO FOR A WALK AROUND THE BUILDING.
• SIT AND BE FIT! (STRETCH BANDS, EXERCISE BALLS, ETC.)
• ALLOW 10 MINUTES TO WRITE IN A JOURNAL.
• GUIDED MEDITATION.
• BACKGROUND MUSIC DURING BREAKS OR RECESS.
• HAVE CLASS OUTSIDE ONE DAY!
DRUGS AND MEDICATION
• WHEN BLOOD PRESSURE IS 140 OR HIGHER FOR YOUR SYSTOLIC
PRESSURE (TOP NUMBER) OR 90 OR HIGHER FOR YOUR DIASTOLIC
PRESSURE (BOTTOM NUMBER), HEALTHCARE PROVIDERS WILL LIKELY
PRESCRIBE MEDICATION IN ADDITION TO LIFESTYLE MODIFICATIONS.
• MORE THAN ONE TYPE OF PRESCRIPTION MEDICATION TO KEEP YOUR
BLOOD PRESSURE AT A HEALTHY LEVEL.
• BLOOD PRESSURE MEDICINES WORK IN DIFFERENT WAYS TO LOWER
BLOOD PRESSURE. SOME REMOVE EXTRA FLUID AND SALT FROM THE
BODY TO LOWER BLOOD PRESSURE. OTHERS SLOW DOWN THE
HEARTBEAT OR RELAX AND WIDEN BLOOD VESSELS.
BROAD CATEGORIES OF MEDICATION FOR CLIENTS
DIURETICS - SOMETIMES CALLED "WATER PILLS" BECAUSE THEY WORK IN THE KIDNEY AND
FLUSH EXCESS WATER AND SODIUM FROM THE BODY.
BETA-BLOCKERS - BETA-BLOCKERS REDUCE NERVE IMPULSES TO THE HEART AND BLOOD
VESSELS. THIS MAKES THE HEART BEAT SLOWER AND WITH LESS FORCE. BLOOD PRESSURE
DROPS AND THE HEART WORKS LESS HARD.
ACE INHIBITORS - ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS PREVENT THE
FORMATION OF A HORMONE CALLED ANGIOTENSIN II, WHICH NORMALLY CAUSES BLOOD
VESSELS TO NARROW. THE ACE INHIBITORS CAUSE THE VESSELS TO RELAX AND BLOOD
PRESSURE GOES DOWN.
ANGIOTENSIN ANTAGONISTS - ANGIOTENSIN ANTAGONISTS SHIELD BLOOD VESSELS FROM
ANGIOTENSIN II. AS A RESULT, THE VESSELS BECOME WIDER AND BLOOD PRESSURE GOES
DOWN.
BROAD CATEGORIES OF MEDICATION FOR CLIENTS
CALCIUM CHANNEL BLOCKERS (CCBS) - CCBS KEEP CALCIUM FROM ENTERING THE MUSCLE
CELLS OF THE HEART AND BLOOD VESSELS. THIS CAUSES THE BLOOD VESSELS TO RELAX
AND PRESSURE GOES DOWN.
ALPHA-BLOCKERS - REDUCE NERVE IMPULSES TO BLOOD VESSELS, WHICH ALLOWS BLOOD
TO PASS MORE EASILY, CAUSING THE BLOOD PRESSURE TO GO DOWN.
ALPHA-BETA-BLOCKERS - WORK THE SAME WAY AS ALPHA-BLOCKERS BUT ALSO SLOW
THE HEARTBEAT, AS BETA-BLOCKERS DO. AS A RESULT, LESS BLOOD IS PUMPED THROUGH
THE VESSELS AND THE BLOOD PRESSURE GOES DOWN.
NERVOUS SYSTEM INHIBITORS - RELAX BLOOD VESSELS BY CONTROLLING NERVE
IMPULSES. THIS CAUSES THE BLOOD VESSELS TO BECOME WIDER AND THE BLOOD
PRESSURE TO GO DOWN.
VASODILATORS - DIRECTLY OPEN BLOOD VESSELS BY RELAXING THE MUSCLE IN THE VESSEL
WALLS, CAUSING THE BLOOD PRESSURE TO GO DOWN.
HYPERTENSION AND WOMEN
• THREE OUT OF FOUR WOMEN WITH HIGH BLOOD PRESSURE KNOW
THEY HAVE IT.
• FEWER THAN ONE IN THREE ARE CONTROLLING THEIR BLOOD
PRESSURE. ALL WOMEN SHOULD TAKE STEPS TO CONTROL THEIR
BLOOD PRESSURE
• CERTAIN CONDITIONS CAN INCREASE BLOOD PRESSURE IN WOMEN.
• PREGNANCY
• ORAL CONTRACEPTIVES
• HORMONE REPLACEMENT THERAPY
ESSENTIAL COPING AND SUPPORT
HIGH BLOOD PRESSURE ISN'T A PROBLEM THAT YOU CAN TREAT AND THEN IGNORE. IT'S A
CONDITION YOU NEED TO MANAGE FOR THE REST OF YOUR LIFE. TO KEEP YOUR
BLOOD PRESSURE UNDER CONTROL:
TAKE YOUR MEDICATIONS PROPERLY. IF SIDE EFFECTS OR COSTS POSE PROBLEMS, DON'T
STOP TAKING YOUR MEDICATIONS. ASK YOUR DOCTOR ABOUT OTHER OPTIONS.
SCHEDULE REGULAR DOCTOR VISITS. IT TAKES A TEAM EFFORT TO TREAT HIGH BLOOD
PRESSURE SUCCESSFULLY. YOUR DOCTOR CAN'T DO IT ALONE, AND NEITHER CAN YOU.
WORK WITH YOUR DOCTOR TO BRING YOUR BLOOD PRESSURE TO A SAFE LEVEL —
AND KEEP IT THERE.
ADOPT HEALTHY HABITS. EAT HEALTHY FOODS, LOSE EXCESS WEIGHT AND GET REGULAR
PHYSICAL ACTIVITY. LIMIT ALCOHOL. IF YOU SMOKE, QUIT.
MANAGE STRESS. SAY NO TO EXTRA TASKS, RELEASE NEGATIVE THOUGHTS, MAINTAIN
GOOD RELATIONSHIPS, AND REMAIN PATIENT AND OPTIMISTIC.
STICKING TO LIFESTYLE CHANGES CAN BE DIFFICULT — ESPECIALLY IF YOU
DON'T SEE OR FEEL ANY SYMPTOMS OF HIGH BLOOD PRESSURE.
TEACHING HYPERTENSION (INSTRUCTORS)
• THE BLOOD PRESSURE MONITOR EXERCISE IS A GREAT HANDS-
ON ACTIVITY THAT WILL TEACH CHWS HOW TO EFFECTIVELY DO
A BLOOD PRESSURE SCREENING. PARTICULARLY EFFECTIVE WITH
TACTILE / KINISTHETIC LEARNERS.
• VISUAL LEARNERS WILL BENEFIT FROM THE MULTIPLE RESOURCES
AVAILABE AT HTTP://WWW.NHLBISUPPORT.COM/
• HAVE STUDENTS RESEARCH AND DEVELOP A RESOURCE LIBRARY
CONTAINING LOCAL AGENCIES, HEALTH DEPARTMENTS, ETC. THAT
PROVIDE MEDICAL AND SOCIAL SUPPORT FOR AT-RISK CLIENTS.
RESOURCES
• THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (PRIMARY SOURCE)
HTTP://WWW.NHLBI.NIH.GOV/
• YOUR GUIDE TO LOWERING BLOOD PRESSURE (DASH)
HTTPS://WWW.NHLBI.NIH.GOV/FILES/DOCS/PUBLIC/HEART/HBP_LOW.PDF
• HIGH BLOOD PRESSURE CONTROL
HTTP://WWW.NHLBI.NIH.GOV/HEALTH/PUBLIC/HEART/HBP/HBPWALLET.PDF
• BMI CALCULATOR
HTTP://WWW.NHLBISUPPORT.COM/BMI/
• MENU PLANNER
HTTP://HP2010.NHLBIHIN.NET/MENUPLANNER/MENU.CGI
RESOURCES
• 10 YEAR CVD RISK CALCULATOR
HTTP://HP2010.NHLBIHIN.NET/ATPIII/CALCULATOR.ASP?USE
RTYPE=PUB
• SMOKING CESSATION
HTTP://WWW.CANCER.ORG/HEALTHY/TOOLSANDCALCUL
ATORS/CALCULATORS/APP/SMOKING-COST-
CALCULATOR.ASPX
• DASH EATING PLAN
HTTP://WWW.NDHEALTH.GOV/HEARTSTROKE/IMAGE/CAC
HE/FACTS_ABOUT_THE_DASH_EATING_PLAN.PDF
PRE- AND POST-TESTING