Arterial hypertension (AH), being the leading risk factor for cardiovascular catastrophes, has recently become a serious burden for health systems of the country. Despite the wide choice of medical and invasive treatment, sufficient control of blood pressure (BP) can hardly be achieved. Consequently, the fight against obvious cardiovascular diseases is equally ineffective, despite the enormous amounts of high-tech assistance available in recent decades. The increased risk of high blood pressure is associated with an unhealthy diet, insufficient physical activity, and excessive body weight. One of the insidious features of arterial hypertension is the complete absence of signs of malaise or poor health in most patients at early and even advanced stages, that is why the study of this health issue is particularly relevant.
To prepare a plan of care for patients suffering from arterial hypertension it is necessary to develop a questionnaire that would allow to assess the basic facts about patients and elaborate effective treatment schemes. The questionnaire should include the following questions:
- What is the age of the patient and his or her gender?
- What is his or her critical mass index?
- How often does he or she measures his or her blood pressure?
- Has he or she taken antihypertension medicines for the last 12 months?
- Have they had any adverse effects to the therapy taken?
- What antihypertension medicines have been taken, in what dose and how often?
- Do the patients stick to the given therapy or do they sometimes forget to take medicines?
- How often were the patients hospitalized for the last 12 months, if any?
- How often did the patients call an ambulance for the last 12 months?
- How do they feel when they forget to take medicines? Are there any relevant changes?
First of all, this questionnaire would allow to assess risk factors for the development of advanced stages of hypertension such as age and critical mass index. Secondly, it would allow to see what medicines patients take and how effective they are for each specific case; adverse effects may also be assessed. Finally, the questionnaire allows to make conclusions to the appropriate therapy for specific patients and change it if there is a need.
Nowadays, hypertension is the most common disease among non-infectious diseases, the consequences of which can lead to various complications. The most dangerous, life–threatening complications of hypertension are severe lesions of the brain, heart stroke and myocardial infarction.
In case of brain damage, as a result of the development of arterial hypertension, a stroke may develop. The consequences of a stroke cannot be predicted, and the recovery period may take a long time.
With arterial hypertension, the heart muscle is forced to work with an increased load, since it needs to contract more in order to push blood into narrowed blood vessels. Over time, as a result of the doubled load, the heart muscle thickens. The coronary arteries supplying the myocardium with blood are not able to properly provide the enlarged heart muscle with oxygen and nutrients necessary for its full operation (Bathgate & Fernandez-Mendoza, 2018). There is oxygen starvation – ischemia of the heart muscle, which is manifested by pain in the thoracic region and can lead to myocardial infarction. The kidneys control the volume of fluid and salt in the body. With progressive arterial hypertension, the kidneys cannot perform their functions at the proper level, which may lead to the development of renal failure. As for morbidity rates, high blood pressure is one of the most important preventable causes of premature death among older and obese population.
The impact of arterial hypertension on the overall health of the nation can hardly be overestimated. It is the most common cause of cardiovascular deceases that annually, together with cancer, become the major reason for deaths among American population. Statistical data on the etiology of arterial hypertension indicate that in 90% of cases the disease develops due to an unhealthy lifestyle, existing bad habits, and only in 10% – for other reasons (Bathgate & Fernandez-Mendoza, 2018). According to statistics, about 30% of the nation’s population report high blood pressure, 2/3 of this contingent suffer from persistent arterial hypertension, and 1/3 from borderline arterial hypertension (Bathgate & Fernandez-Mendoza, 2018). The proportion of the population aged 65 and older suffering from hypertension is more than 50% of the total population of this age (Bathgate & Fernandez-Mendoza, 2018). The proportion of persons suffering from hypertension among the male and female population has proved that men are more susceptible to the disease than women. The data obtained indicate a high prevalence of hypertension among the population of the United States and low awareness of patients about their disease, especially among men. This is due to the continuing problems in the diagnosis, treatment and prevention of hypertension, as well as the clinical observation of people with high blood pressure.
The health issue of high blood pressure is based on the Leading Health Indicator (LHI) priority from Healthy People called ‘increase control of high blood pressure in adults — HDS‑05’. The aim set by this indicator is to achieve significant diminishing in new cases of high blood pressure among adults through promoting healthy habits and lifestyle. To minimize the risk of developing high blood pressure and its adverse effects, everyone can take a number of specific steps.
First of all, mental well-being and a positive emotional state are indispensable conditions for maintaining health. This is especially important for patients with hypertension or predisposed to its development, because the disease is directly related to an inadequate response to stress. It is necessary to learn how to manage stress in such healthy ways as meditation, various types of psychotherapy and positive social contacts.
The second component of the prevention of hypertension is sufficient activity. For a city dweller, it will be optimal to walk at least 1 hour daily in a forested area. Patients with hypertension that has already manifested itself should engage in physical therapy. Moreover, it is necessary to alternate work and rest; overwork of any type, both mental and physical, should be avoided. Healthy physiological sleep, at least 8 or 9 hours a day, is instrumental in reducing the levels of high blood pressure.
The reduction of excess weight or the treatment of obesity is the main factor that can lead to satisfactory control of blood pressure. An effective means to normalize weight is diet therapy and various types of physical activity. Healthy eating habits should include a large number of proteins with the reduction of carbohydrates and fats. In the prevention of hypertension, proper nutrition or diet is of great importance.
Arterial hypertension has become the burden of the 21st century. Characterized by absence of signs at initial stages, the decease is not taken seriously by many patients, which results in high rates of comorbidity and deaths. Including high blood pressure in Leading Health Indicator priority from Healthy People may improve the situation, if doctors, nurses, and patients work collaboratively to put a stop to the spread of the decease.
Reference
Bathgate, C. J., & Fernandez-Mendoza, J. (2018). Insomnia, short sleep duration, and high blood pressure: recent evidence and future directions for the prevention and management of hypertension. Current hypertension reports, 20(6), 1-10. Barner, C. (2012). Social media and communication. Sage.