Hypertension or high blood pressure has been one of those chronic diseases that have plagued the United States. Approximately, 73.6 million adults suffer from hypertension. It is estimated that 77.6% of patients are aware of their hypertension and is being treated. However, only 44% of patients have their blood pressure under control. Hypertension takes years to develop. Uncontrolled high blood pressure can increase the risk of serious health problems such as cerebrovascular, cardiovascular, and renal disease by the age of 50. Hypertension can shorten one’s lifespan by 5 years. Hypertension is a complex disease that involves several factors contributing to its development.
Depending on the balance between cardiac output and systemic vascular resistance, hypertension can develop. The cardiac stroke volume and heart rate make up the cardiac output. Stroke volume is determined by the myocontractility and preload. Systemic vascular resistance entails the vessel elasticity, myoconractility, and afterload. When hypertension occurs, there is a malfunction disorder in the cardiac output or systemic vascular resistance or both. There are several physiological mechanisms that are included in the process of maintaining blood pressure: glucocorticoid steroids, mineralocorticoid, endothelins, atrial natriuretic peptide, arterial baroreceptors, and the renin-angiotensin- aldosterone system. To maintain a decent flow of blood, vasodilatation or vasoconstriction takes place. Also, the retention or excretion of sodium and water occur in the systemic circulation. As a person ages, a person’s blood vessel tends to become less elastic and more rigid. Stiff, hard vessels cause vasodilatation that increases the systemic vascular re...
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...diabetes 9 years or more. In the study group, 55.7% were currently taking antihypertensive. The most common medication used in the group were ACE inhibitors, then angiotensin receptor blockers, beta blockers, calcium channel blockers and finally diuretics. However, 30% of the diabetic’s blood pressure was not controlled. Of the group, the diabetics were using monotherapy. There were sixty patients who only used an ACE inhibitor for blood pressure control. It was suggested that ACE inhibitors work better wit combined medications. During this study, JNC 7 used and it mentioned that the combination of ACE inhibitors with a combination of drugs worked well together. The combination of the ACE inhibitor and beta-blockers do not work well together. Compliance was important in improving blood pressure. Providers need to be selective in prescribing hypertensive medication.
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