Introduction
Cardiovascular disease (CVD) and chronic kidney disease (CKD) closely parallel the obesity and insulin resistance epidemic. Current U.S. estimates project 70 million obese adults and an additional 70 million with hypertension and/or type II diabetes (28, 42, 45). More so, the National Health and Nutrition Examination Survey (NHANES), suggest a graded and continuous relationship exists between prevalent hypertension and increasing body mass index (BMI); a metric that is closely associated with insulin resistance and self-identified type II diabetes (8, 34).
Latent diabetic vascular complications are a hallmark of the disease and known to significantly affect the cardiovascular and renal systems. Atherosclerosis is the main reason for decreased life expectancy in patients with diabetes, whereas diabetic nephropathy and retinopathy are the largest contributors to end-stage renal disease and blindness, respectively (37, 56). Current therapy is aimed at managing blood glucose concentrations and increasing insulin resistance. Thus, vascular complication mitigation includes: blood glucose monitoring and lowering, which decreases the risk of nephropathy and retinopathy. Antihypertensive medicine is also utilized to decrease the risk of cardiovascular disease, nephropathy, and retinopathy (15, 26). As well, hypertension is closely associated with stroke and pulmonary edema. Despite these advances, diabetes complications and their treatments are aimed at abating symptoms in an effort to improve physiological function.
Atherosclerosis in Diabetes
Atherosclerotic lesions in patients with diabetes are indistinguishable from lesions in patients in whom another characteristic, like hypercholesterolemia or smoking, is the major ...
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...hole-body insulin resistance in skeletal muscles (11, 32, 43). It should not be discounted though that the MR also has a high affinity for both aldosterone and 11β-hydroxy-glucocorticoids, which exist in lower levels in non-epithelial tissues that allow glucocorticoids to signal through the MR in cardiovascular and metabolic tissue such as skeletal muscle, liver and fat (72). Not a marginal point as insulin resistant populations have plasma glucocorticoid concentrations are greater than those of aldosterone and this may promote MR activation by glucocorticoids. Potentiating the oxidative stress in the cardio-renal metabolic syndrome (71). Indepdent of the in-/direct mechanism, the evidence of RAAS blockade or silencing can ameliorate oxidative stress, improves endothelial function and contributes to reductions of hypertension in the cardio-renal metabolic phenotype.
How does this history of high blood pressure demonstrate the problem description and etiology components of the P.E.R.I.E. process? What different types of studies were used to establish etiology or contributory cause?
The Mayo Clinic’s book on High Blood Pressure was full of detailed facts about blood pressure and what it is. This is extremely significant to the experiment because blood pressure is one of the variables being tested. Understanding blood pressure is one of the key components to receiving accurate results from this experiment. Most of the book is on high blood pressure, which is not necessary for the experiment, but the book still had plenty of useful information about blood pressure itself. The book explains that when the heart beats, a surge of blood is released from the left ventricle. It also tells of how arteries are blood vessels that move nutrients and oxygenated blood from the heart to the body’s tissues. The aorta, or the largest artery in the heart, is connected to the left ventricle and is the main place for blood to leave the heart as the aorta branches off into many different smaller
Fluid from the intravascular space shifts into the interstitial space surrounding the cells. This shift is caused by increased hydrostatic pressure within capillaries as the result of reduced liver function blocking blood flow. Increased capillary permeability from inflammation pushes albumin into the interstitial space, increasing interstitial osmotic pressure and deceasing capillary osmotic pressure. Due to decreased liver function, albumin is not longer readily made decreasing its presence in body. Without albumin, osmotic pressure will remain decreased within the plasma. As the body compensates for this loss of water and increased sodium in the intravascular space hypertonic alterations pull water from the intracellular fluid causing
Obesity remains an extremely serious issue worldwide. Once considered a problem for wealthier counties, overweight and obesity are now dramatically increasing in low and middle income countries (WHO, 2011). In American, the rates of obesity continue to soar. CDC (2009) recognizes obesity as a risk factor for diabetes, heart disease, high blood pressure, and other health problems. According to NHANES over two-thirds of the US are overweight or obese, and over one-third are obese (CDC, 2009). Treatment for this illness varies; it may include the incorporation of diet, exercise, behavior modification, medication, and surgery. Since there is no single cause of all overweight and obesity, there is no single way to prevent or treat overweight and obesity that will help everyone (CDC, 2009).
Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Hypertension is another term used to describe high blood pressure. This common condition increases the risk for heart disease and stroke, two leading causes of death for Americans. High blood pressure contributed to more than 362,895 deaths in the United States during 2010. Approximately 67 million persons in the United States have high blood pressure, and only half of those have their condition under control. An estimated 46,000 deaths could be avoided annually if 70% of patients with high blood pressure were treated according to published guidelines (Patel, Datu, Roman, Barton, Ritchey, Wall, Loustalot; 2014).
B.(Sub-point) Type-2 diabetes after a long time can affect the body’s blood vessels leading to damage to both small and big vessels just like Type 1 diabetes. (SUB-SUBPOINT) Damage to the small blood vessel leads to microvascular problems, while harm to the large vessels result in macrovascular effects (Lisa, 2016). Impaired blood vessels do not transfer blood as supposed to, which results in other complications, like vision loss, kidney damage and nerve damage. Macrovascular problems with Type 2 diabetes are a buildup of plaque, which results in a heart attack, blocked vessels in legs and a stroke (Lisa, 2016). Type 1 diabetes has the same complications as Type 2 resulting in the same effect on the important organs in the body, like the heart, nerves, vision, kidneys and both the tiny and large blood vessels ( Mayo Clinic Staff,
“Obesity Information.” American Heart Association Obesity Information. American heart Association, 27 February 2014. Web. 04 Apr. 2014
Diabetes Mellitus, Type 2 is a metabolic disorder that is related to increased glucose levels in the blood, which is known as hyperglycemia. Insulin under typical function aids in carrying glucose from the body’s bloodstream into cells. However, in DM II, insulin production is hindered, insulin receptors are more resistant, and/or there is an inappropriate secretion of glucagon. This causes glucose to increase in the blood since there are not enough functioning insulin receptors to help transfer glucose to cells. Chronic elevated glucose levels damage small blood vessel resulting in peripheral neuropathy, retinopathy, and acceleration of atherosclerosis. The elevated levels also impair immune function and wound healing ability (Lippincott Williams & Wilkins, 2011).
Complications related to diabetes and nephropathy are said to account for 50% of new cases of end stage renal disease (...
Throughout history, it seems that medicine and spirituality have been linked in many circumstances. In a study looking at the use of complementary and alternative therapies in cardiac patients, spiritual healing was one of many practices patient sought to utilize. In another study, 29% of participants chose to use prayer or premeditation as a way to cope with their chronic illness. In both studies, prayer or meditation was more likely to be used by individuals who had a large social network, as well as support from another person in the same health situation. Based on these studies, it seems that many individuals (not just cardiovascular patients) turn to their spirituality in times of health distress.
2005) Local RAAS has been implicated as a key player in the pathogenesis of cardiovascular and renal diseases. Intrarenal RAAS is activated early in diabetic nephropathy, the leading cause of CKD.(Siragy and Carey 2010) Intracardiac RAAS may contribute to myocardial hypertrophy and remodeling.(Hayashida et al. 1993) Production of Aldosterone and Angiotensin Converting Enzyme (ACE) and selective downregulation of specific angiotensin II receptors has been observed in the failing heart(Mizuno et al. 2001)(Silvestre et al. 1999) (Asano et al. 1997)(Haywood et al. 1997)(Zisman et al. 1998). In addition to their direct effects, RAAS elements may also have indirect pathological effects through influencing factors like sympathetic activity(Grassi et al. 1997)(Dibner-Dunlap et al. 1996)(Latini 2002) level of kinins(Witherow et al. 2001), endothelial function(Hornig et al. 1998)(Clavell et al. 1996), and/or cytokine levels. (Gullestad et al. 1999)(Tsutamoto et al.
Diabetic retinopathy is a progressive disease in which there are four stages: Mild Nonproliferative Retinopathy, Moderate Nonproliferative Retinopathy, Severe Nonproliferative Retinopathy, and Proliferative Retinopathy. In stage two Moderate Nonproliferative Retinopathy, the tiny blood vessels that nourish the retina become blocked. As the condition continues to progress, more and more blood vessels become blocked and the retina sends signals for more blood vessels to be made. These new vessels break easily, le...
Vicki is a 42-year-old African American woman who was diagnosed with Hypertension a month ago. She has been married to her high school sweetheart for the past 20 years. She is self-employed and runs a successful insurance agency. Her work requires frequent travel and Vicki often has to eat at fast food restaurants for most of her meals. A poor diet that is high in salt and fat and low in nutrients for the body and stress from her job are contributing factors of Vicki’s diagnosis of hypertension. This paper will discuss the diagnostic testing, Complementary and Alternative Medicine treatments, the prognosis for hypertension, appropriate treatment for Vicki, patient education, and potential barriers to therapy that Vicki may experience.
Although many individuals are uncertain about the increasing statistics associated with obesity, more than seventy percent of men and virtually sixty-two percent of women within the United States adult population are overweight or obese (Wilmore, Costill, & Kenney). Obesity refers to the condition of having an excessive amount of body fat. If an individual’s amount of body fat becomes too excessive, he/she is at a much greater risk of developing life-altering diseases such as heart failure, hypertension, type II diabetes, cancer, gallbladder disease, osteoarthritis, etc. (Wilmore, et al., 2008).
There is a positive correlation between body mass index and blood pressure measurement; as BMI reaches normal range, blood pressure measurement stability improves towards the normal range. Blood glucose and hemoglobin A1c levels are dependent on insulin up-take. A reduction of insulin resistance due to obesity will result in an improve blood glucose and A1c readings. Dietary lifestyle changes such as reduction of sodium intake, alcohol, fatty foods, and high-sugary foods has been essential to reducing and/eliminating harmful medical risks pertaining to these three chronic conditions (Zanella, Kohlmann, & Ribeiro,