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pharmacotherapy of hypertension
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Hypertension is one of the commonest chronic diseases in British primary care . It is also a major risk contributor for coronary heart disease and cardiovascular disease for example stroke and myocardial infarction. , Hypertension is also a global health problem affecting people of different ethnicity and ages around the world. The UK population which consists of varies ethnic groups for example Caucasians, Afro-Caribbean, Asians and many more might illustrated the problem. Hypertension is usually asymptomatic .The higher the blood pressure measurement, the greater the risk. Therefore screening for it is very vital to avoid secondary complication of the disease.
High blood pressure is defined as having blood pressure above than 140/90 each time the measurement is taken. In other word is called sustained blood pressure. Unfortunately it is not as simple as that to consider a person to have hypertension. This is because the level of blood pressure can vary from person to person. This condition happened due to the presence of various risk factor and contributor that can promote hypertension including, genetic, alcohol intake, level of cholesterol, obesity, lifestyle and organ damage. Therefore, blood pressure has a skewed normal distribution within the population and the risk is continuously related to it.
The British Hypertension Society (BHS) and National Institute for Health and Clinical Excellence (NICE) have provided national guideline and recommendations for primary care to manage hypertension in community. This audit is going to look at the management and treatment of hypertension in the community practice by referring to latest BHS and NICE guideline for hypertension.
Works Cited
1 Lane DA and Lip GYH. Ethnic differences in hypertension and blood pressure control in the UK. Q J Med 2001; 94: 391-396© 2001 Association of Physicians. Available from: http://qjmed.oxfordjournals.org/cgi/content/full/94/7/391
2 Standing P; Deakin H; Norman P; Standing R. Hypertension: Its Detection, Prevalence, Control and Treatment in a Quality Driven British General Practice. Br J Cardiol. 2005;12(6):471-476. © 2005 Medinews (Cardiology) Limited. Available from: http://www.medscape.com/viewarticle/521162
3 Underwood P, Beck P. UK Secondary prevention following myocardial infarction: evidence from an audit in South Wales that the National Service Framework for coronary heart disease does not address all the issues.
As early as the 1800s clinicians began to take a closer look at elevated blood pressure levels, they soon found high correlation between hypertension, stroke, and other heart diseases. They also established that high levels of blood pressure effected both privilege and underprivileged, and within the years they have noted the disease have become more prevalent in the African American culture. Long term studies, such as randomized controlled trial studies, unveiled
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Some people may experience: bad headache, mild dizziness, and blurry vision. Traditionally, diagnosis of high blood pressure (BP) has relied on consecutive checks of clinic BP over a 2 to 3 month period, with hypertension confirmed if BP remains persistently raised over 140/90 mmHg. This method of diagnosis has significant limitations because the BP measured for an individual patient in a clinic setting may not reflect their BP in day-to-day life. The main concern is that as a result of the “white coat syndrome”, hypertension may be over-diagnosed when checked in the clinic setting; resulting ...
The causes of hypertension are unknown. However; hypertension can be classified into two categories primary and secondary. Primary (essential) hypertension is increas...
Hypertension is diagnosed by measuring the blood pressure by a device known as the sphygmomanometer. Blood pressure is taken and presented by the systolic blood pressure and diastolic blood pressure. The systolic and diastolic numbers will be recorded and compared to a chart of values. At the same time, doctor would also ask for patient’s family history of hypertension and the associated risk factors such as high cholesterol food intake.
William, W. D. (2004). Culture and the risk of disease. British Medical Bulletin, 69, 21-31. doi: 10.1093/bmb/ldh020
As mentioned, one of the go to forms of treatment is medication. “ These could include medications to lower your blood pressure, such as diuretics, angiogenesis-converting enzyme (ACE) inhibitors or beta blockers; blood thinning medications, such as daily aspirin therapy; or cholesterol-lowering medications, such as statins or fibrates”(Mayo Clinic). These medications have been successful in their attempts to lower these risk factors and have been helpful when underlying genetic conditions and age become a factor; however, when these problems stem from au unhealthy lifestyle it is import to understand that these risks will never fully go away until sweeping changes are made.
As many as 73 million Americans have high blood pressure. Of the 1 in every 4 adults wi...
" Journal of Clinical Hypertension 13.5 (2011): 351-56. EBSOHost.com - a. Web. The Web.
Mrs. Andrews hypertension is mild at 146/96 which leads to the recommendation of lifestyle modification opposed to pharmacological treatment. In a study led by the American Heart Association, “lifestyle interventions received class I recommendations (Mosca et al., 2004, p. 675)” to prevent major cardiovascular issues in women. There are several useful tools and programs available to assist patients making lifestyle changes. A couple of examples of programs are the WISEWOMAN and Therapeutic Lifestyle Changes (TLC). WISEWOMAN is a “program funded by the CDC that provides low income uninsured women (40-64) with chronic disease risk factor screening, lifestyle modification interventions, and referral services to prevent CAD (Schroetter & Peck, 2008, p. 109).” TLC is “an effective lifestyle therapy recommended by the American Diabetes Association, the American Heart Association, and the Obesity Society ("Can TLC ...
Smith, D et al (2000) Ethnic inequalities in health: A review of UK epidemiological evidence. Critical Public Health. [pdf] 10 (4) pp. 375 – 408. Available through: Taylor and Francis Online [Accessed 28 November 2011]
Hypertension is a developing problem worldwide,associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%, compared to white males at 31.5% of the population. The hypertension rate of black females was more than twice that of white females. The death rate from hypertension among black males was 51.8 per 100,000, and among black females was 40.4 per 100,000; however, the morta...
The review of literature corresponds to the African Americans risk of getting hypertension. It showed that African American are at a higher risk for hypertension because many of them are unwilling to seek medical care and even when they do they do not take their medications as prescribed.
Blood pressure is measured by two pressures; the systolic and diastolic. The systolic pressure, the top number, is the pressure in the arteries when the heart contracts. The diastolic pressure, the bottom number, measures the pressure between heartbeats. A normal blood pressure is when the systolic pressure is less than 120mmHg and Diastolic pressure is less than 80mmHg. Hypertension is diagnosed when the systolic pressure is greater than 140mmHg and the diastolic pressure is greater than 90mmHg. The physician may also ask about medical history, family history, life style habits, and medication use that could also contribute to hypertension
WILLIAMS, P and POULTER NR et al (2004) Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society. British Hypertension Society, pp. 139-85
Schnall, P., Landsbergis, P., Belkic, K., Warren, K., Schwartz, J., & Pickering, T. (1998). Findings In The Cornell University Ambulatory Blood Pressure Worksite Study: A Review. Psychosomatic Medicine, 60, 697.