Introduction
According to current research, the best method for managing hypertension is through dietary plans, which include recommendations of offered by the government-approved dieticians. Patients that exhibit symptoms of hypertension can be placed on diet plans, such as the Standard American Diet (SAD) and Dietary Approaches to Stop Hypertension (DASH). These diets are government approved and contribute significantly to the reduction of hypertension rates in patients. Alternatively, hypertension can be managed through transcendental approaches to manage stress and anxiety, which are risk factors for the condition. Moreover, hypertension can be treated using garlic, green teas, flax seeds, and probiotics, as proven by randomized control trials in clinical settings ( Welcome to the Natural Medicines Research Collaboration. (2019) . Lastly, hypertension patients can consult websites that provide information on ways they can manage the condition, primarily without using medications that have negative side-effects. Even though low sodium diets, weight control, and stress management are proven methods to reduce high blood pressure in people with hypertension, lifestyle changes complemented by holistic health and nutrition may lessen the need for conventional pharmaceuticals over time.
Background Information
Hypertension is a chronic illness that poses significant public health challenges and burden to Americans today. The disease is costly to treat, requires near-lifetime management, and results in other morbidities, such as cardiovascular conditions and stroke in extreme conditions. Defined as diastolic blood pressure of ≥ 90 and systolic levels of ≥140, hypertension is a global health problem that affects persons, such as patients, their families, and clinical professionals significantly. Several studies have projected the rates at which the world population is increasingly manifesting hypertension, and this worrying trend necessitates the institution of remedies, such as non-pharmacological interventions to limit its spread. For instance, according to Burnier and Egan (2019), up to 918 people in the world had hypertension, and this statistics is projected to rise by 2025 to 1.56 billion people. The above statistics may be translated as an increase in hypertension rates from 26.4% in 2000 to 29.2% in 2025, an alarming growth rate that makes it essential for the global population to be educated on ways it can manage the condition or methods that prevent their acquisition of the disease (Burnier & Egan, 2019). Hypertension rates have also been noted to be higher in high-income countries compared to low-income nations, and this has contributed to governments of high-prevalence nations creating strategies that help to manage the condition.
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Dangers of Hypertension
Hypertension is a public health concern that increases the prevalence of patients acquiring morbidities in the long-run. Patients that have this condition may acquire illnesses, such as kidney disease, heart failure, heart attack, and stroke. These conditions can be explained by the etiology and pathophysiology of the disease, as it disrupts regular blood flow in the body significantly. Essential hypertension, which is most common and whose cause cannot be determined clinically, is caused by multiple issues, such as adrenal disease that causes blood pressure to rise at an alarming rate. Medical practitioners report an imbalance between the peripheral vascular resistance and cardiac output in many patients that have hypertension. The patients have a typical cardiac output rate as other healthy people but their peripheral vascular resistance rates are significantly high. In these patients, smooth muscles walls strain to contract, raisin the intracellular concentrations of sodium. Consequently, the arterial structural walls thicken, and this causes the patient to exhibit external symptoms of hypertension, such as chest pain, shortness of breath, and irregular heartbeat. In extreme circumstances, the patient acquires morbidities, such as damage of the heart and blood vessels.
Hypertension can also be caused by kidney failure, when the renal system that is responsible for the excretion of excessive salts fails to perform its typical functions as in a healthy individual. In patients with hypertension, the renal system does not regulate sodium intake and in the long-run, this results in the development of lower renin levels. Often, patients are given treatment to increase their renin levels but in hypertensive patients, these medications are rarely effective, primarily in older adults. Lastly, hypertension can be caused by endothelial dysfunction, when endothelial cells of the vascular system that control vasodilation and vasoconstriction fail. If the patient has been diagnosed with established hypertension, they are then at risk of complications such as heart failure and stroke which are often fatal. Therefore, hypertension is a public health concern that results from multiple system damages and causes patients to acquire morbidities, such as kidney failure, cardiac arrest, or stroke.
Current Treatments
Hypertension rates across the world have been discussed by several scholars, who give varying views on current and future statistics, which medical practitioners should be wary of. There are several interventions that have already been instituted to help in the management of hypertension or to prevent the current population across the world from acquiring it. For instance, there are clinics that use holistic approach as a patient-centered strategy to care for hypertensive convalescents, in addition to using pharmacological interventions. For instance, if a patient reports to the emergency section of the clinic and they appear to be manifesting symptoms of pulmonary arterial hypertension, the best medical approach to treat them would be to use pharmacological techniques to lower their blood pressure. The patient may be subjected to emergency medications such as diuretics which helps to reduce their blood pressure quickly.
Mental Health Assessment as a Method of Intervention
As the patient stabilizes, some clinics will then assess them for risk factors that cause their blood pressure to spike, such as stress and anxiety. The patient may report that prior to their being admitted for hypertension, they were stressed and anxious, or they were experiencing difficulties in maintaining their relationships. Additionally, the patient may report that before they were admitted for blood pressure spike, they were having intense difficulties in accepting their body images or they were experiencing severe issues financially, which made them feel anxious nearly all the time. The clinic, therefore, accords the hypertensive patient mental healthcare in addition to pharmacological interventions, as a way to help them process the emotions that cause their cardiovascular systems to dysfunction. According to current research, the use of mental health assessment as an additional patient-centered, intervention strategy is effective for up to 56% of patients ( Bryan & Kelemen, 2018 ). Below is a graphical representation of the effectiveness of mental healthcare intervention as a treatment strategy for hypertensive patients.
Figure 1: Pie chart representing effectiveness of mental healthcare intervention
Red: Percentage of patients who feel the intervention is ineffective
Blue: Percentage of patients who feel the intervention is effective
Diet and Exercise
Hypertension can also be managed by ensuring the patient adheres to a strict exercise regime and balanced diet. The benefits of these intervention techniques is that they are cost-effective and do not have negative side-effects, such as anxiety that is common in patients that use medication to manage hypertension. In many cases, patients that manifest hypertensive symptoms are overweight, and this affects their metabolism significantly, creating an enabling environment for the condition to develop. One way healthcare practitioners can help hypertensive patients to lose weight is by recommending that they frequently exercise. The patient should engage in moderate to intense aerobic exercise to redistribute cardiac output, such as circuit training and weight-lifting. When the hypertensive patient exercises, they trigger their hydrostatic and neuro-hormonal mechanisms, which regulate the systolic and diastolic heart rates to help the patient’s vascular system perform its typical functions as in a healthy individual. If the patient exercises regularly, they begin to enjoy post-exercise benefits as their physiology responds positively. For instance, the vascular walls that control vasodilation and vasoconstriction regain their regular functioning when hypertensive patients exercise regularly, and this prevents their susceptibility to acquire conditions, such as stroke or heart failure. Patients’ exercising should be done purposefully with the intention for recovery from hypertension, necessitating that the trainee engages in rigorous or moderate movement of muscles and joints. Medical practitioners should recommend that a patient exercises up to three times a week for positive effects of the intervention to be realized.
Patients can also eat healthy diets to help them manage hypertension. Instead of giving patients medications that have negative side-effects, medical practitioners can recommend that they eat balanced diets to help them regulate their weight-gain, which enables hypertension to develop. The patient should be advised against eating foods that are rich in sodium as this is part of the leading reasons they develop hypertension, which is caused by kidney functioning failure ( Crittenden et al., 2017) . Additionally, the medical practitioner should recommend that a hypertensive patient eats natural fats, such as fatty fish, pumpkin seeds, tofu, flaxseeds, and soy milk. These fats are easily absorbed by the body and do not cause the cardiovascular system to strain, a condition that may cause an individual to develop hypertension. Patients should also eat meals that have proteins, vegetables, and fruits. These food servings are easily digested by the body, do not strain the cardiovascular and kidney system, and thereby protect the patient from acquiring hypertension. When patients eat a low-salt, well-balanced diet, they also benefit in that they acquire the ability to control their weight, a significant cause of hypertension in many individuals. According to current studies, diet and exercise are effective ways to manage hypertension as it reduces the systolic pressure by up to 11 mm Hg. This statistic is represented in the graph below:
Figure 2: Graphical representation of the systolic rate reduction after diet and exercise intervention
Category 1: Systolic pressure after exercise and diet intervention
Category 2: Systolic pressure before exercise and diet intervention
Cost Analysis Matrix Approaches
Hypertension in patients can also be managed through other non-pharmacological interventions that are less costly than medications. These interventions help the patient to recover progressively and have been recommended by several researchers as better than restricting convalescents to taking medications to help them manage hypertension. According to current research, even of pharmacological methods of treating hypertension are effective, many patients do not enjoy their full benefits because they rarely adhere to treatment protocols. In the end, patients have lower quality of life because they cannot take medication as prescribed within the recommended dosage. Many hypertensive patients do not complete their medications on time, and this behavior is costly in the long run as the disease progresses to other morbidities, such as kidney and heart failure. Therefore, as a way to curb non-adherence to medications effects in hypertensive patients, it is essential that they be advised to use alternative treatment strategies, such as diets recommended by government nutritionists, biofeedback, and meditation.
Solution: DASH and SAD Eating Plans
High blood pressure in patients can be managed using the Dietary Approaches to Stop Hypertension (DASH) strategy. Under this method of managing hypertension devised by the National Institute of Health, patients are advised to avoid the modern North-American food diet, which comprises fatty acids, artificial additives, and saturated fats. Instead, the hypertensive patient is subjected to the DASH dietary intervention strictly and is restricted from trying other ways of managing the condition, such as exercise and taking medications. A typical DASH diet comprises five servings of fruit daily, seven servings of carbohydrates, five servings of vegetables, and two servings of lean meats every day. The patient is also instructed to eat 3 servings of nuts weekly and two servings of dairy products that have low-fat content in a day. Hypertensive patients are advised to eat carbohydrates, such as beans, legumes, leafy, green vegetables, and index fruits that have a low value of glycemic nutritional content ( Hypertension (High Blood Pressure), n.d.) . The primary aim for patients eating these carbohydrates prescribed by the DASH diet is so that they can benefit from the micronutrients these foods have, which help in reducing hypertension in patients significantly.
The DASH diet also prescribes that patients eat foods that are rich in fats, which play a primary role in prevention of inflammation of the vascular walls, an aspect that triggers the development of hypertension. Sources of fats for patient consumption recommended by the DASH diet to reduce hypertension include flax seeds, nuts, avocados, hempseeds, and olive oil. The DASH diet also restricts patients from taking artificial fats, such as margarine, hydrogenated vegetable oils, and vegetable shortenings. Lastly, hypertensive patients that consume meals as prescribed by the DASH diet include lean meats, dairy eggs, nuts, seeds, and soy products. According to current research, the DASH diet, when strictly observed by a hypertensive patient, reduces their levels of weight-gain and consequently, their systolic blood pressure rates. The DASH diet lowers saturated fats and cholesterol in patients, which in turn helps in the management of hypertension in patients.
Patients can also eat the Standard American Diet (SAD), which has been proven to be effective in the management of hypertension. The SAD diet was created by the federal government as a way to encourage Americans to eat quality foods to reduce the prevalence of chronic illnesses that were being reported in healthcare facilities. Additionally, the SAD diet as designed to help the federal government reduce costs associated with the reported chronic illnesses, their associated morbidities, and mortality rates that were beginning to rise alarmingly. Under this diet, hypertensive patients are advised to adhere to meal in-takes that comprise foods, such as whole fruits, plant proteins, empty calories, and greens ( Hypertension (High Blood Pressure ), n.d.) . Hypertensive patients using the SAD diet meal-plan also take beans, vegetables, sea food, and refined grains. In the long-run, these patients report declined rates of systolic rates and their overall blood pressure reduces significantly.
Solution: Transcendental Meditation
Current research also proves that hypertension in patients can be reduced through cost-effective transcendental meditation, yoga, and tai chi relaxation techniques. These interventions target the reduction of anxiety and stress, which are often the primary causes of hypertension in patients. Under these management methods, patients attend a meditation session where they reflect on their current situations that trigger increases in blood pressure and then process the effects in a quiet environment. Inner reflection enhanced by meditation techniques, such as yoga and tai chi, helps the patient manage distress in their everyday living conditions and consequently reduce their susceptibility to have high blood pressure ( Complementary Health Approaches for Hypertension, n.d.) . When patients meditate, they heal their inner mind and soul, and this helps them to manage scenarios that would cause them to have anxiety and stress, which are primary triggers of hypertension. The patient that regularly practices meditation attains a transcendental state, where they are purely conscious of their bodies, actions, and this helps them to limit the regulation of cortisol stress hormones. In the long-run, meditation is an effective way to control blood pressure condition in patients because it helps in the inhibition of stress and anxiety that trigger hypertension.
Solution: Biofeedback
Hypertensive patients can also regulate their condition through biofeedback, which is cost-effective and efficient. The medical practitioner subjects the patient to an electronic assessment of their biological functioning under this procedure, which identifies malfunctioning systems within the body. For instance, after the above exercise, the physician may note that the patient’s vascular walls are thickened or that they have failed kidneys that need medical attention ( Hypertension (High Blood Pressure), n.d.) . The physician may also realize that the patient cardiovascular system is overworked or that they have high levels of sodium, which are risk factors for hypertension. The results of a biofeedback may be helpful in that it pinpoints aspects that can accelerate a patient’s blood pressure and allows for the immediate creation of remedies.
Solution: Supplementation
The hypertensive patient can also use supplements instead of medication to manage their condition. Foods that help in the relaxation of the vascular system and inhibit the accumulation of sodium in the body, such as garlic, green tea, hibiscus, and probiotics have been proven to reduce blood pressure by current researchers ( Welcome to the Natural Medicines Research Collaboration, 2019) . Instead of the patient taking medications that have strong side-effects, physicians can recommend supplements that will help in the management of hypertension. These supplements are safe for patients of all ages that have high blood pressure, increasing their effectiveness in treating the condition. Supplements are also less costly than medications and regular consultation fees, thereby making them effective ways of managing hypertension.
Useful Resources
Patients can access useful resources that have information on the management of hypertension, such as websites. For instance, the Centers for Disease Control website have information on cost-friendly, alternative techniques that patients can use to manage hypertension. Hypertensive patients can also access the “Advances in Pulmonary Hypertension” and National Center for Complimentary and Integrative Health websites to learn alternative management methods for the condition.
Public Campaign
The public should be educated about the availability of alternative methods for effective management of hypertension. This civic education can be conducted through cross-media campaign, which should be executed thoroughly. Education on the possibility for a DASH and SAD diet helping in managing hypertension should be advanced using platforms, such as Facebook, Twitter, and Instagram. These social media pages have millions of users that would benefit from information about the benefits of eating a well-balanced diet and low-sodium content in reducing systolic pressure. Additionally, the public should be educated on the benefits of biofeedback and supplementation in managing hypertension. Education concerning these methods can be advanced using platforms, such as YouTube pop-up ads, school curricula, and print and broadcast media. Lastly, hypertensive patients should be informed about their right to request for a comprehensive mental health assessment after they receive pharmacological interventions, so that they can identify the root causes of their condition and use techniques, such as meditation, yoga, and tai chi to process how they promote their condition intensifying.
Conclusion
Hypertension is a chronic illness characterized by high blood pressure, whose treatment is costly for convalescents. The hypertensive patient relies on medication for a lifetime to regulate the condition, and this exacerbates their stress and anxiety considerably. Patients that have hypertension are at risk of acquiring morbidities, such as stroke and heart failure. However, instead of solely relying on medication for treatment of hypertension, patients can use alternatives that are cost-friendly. Current research proves that patients can reduce the prevalence of their hypertensive conditions by using non-pharmacological interventions, such as supplements, meditation, biofeedback, and the DASH and SAD eating plans. These techniques help in the relaxation of the cardiovascular system, significantly reducing the systolic pressure in patients that have been diagnosed with hypertension.
It is essential for healthcare practitioners to regularly incorporate the mentioned non-pharmacological strategies in their management of hypertension. Patients should receive comprehensive education on the benefits of alternative interventions, such as reduced cost of treatment and safety. Physicians should also educate patients about advantages of non-medication management techniques of high blood pressure, such as resultant weight-loss that inhibits their acquiring of obesity, which has more negative side-effects, such as failure of the cardiovascular system. The prevalence of hypertension across the world documented by several researchers will decline significantly if medical practitioners also integrate the discussed management methods for hypertension.
References
Bryan, L., & Kelemen, A. (2018). Holistic Care for Patients With Pulmonary Hypertension. Advances in Pulmonary Hypertension, 17(1), 32–33. https://doi.org/10.21693/1933-088x-17.1.32
Burnier, M., & Egan, B. M. (2019). Adherence in Hypertension. Circulation Research, 124(7), 1124–1140. https://doi.org/10.1161/circresaha.118.313220
Complementary Health Approaches for Hypertension. (n.d.). NCCIH. https://www.nccih.nih.gov/health/providers/digest/complementary-health-approaches-forhypertension
Crittenden, D., Seibenhener, S., & Hamilton, B. (2017). Health Coaching and the Management of Hypertension. The Journal for Nurse Practitioners, 13(5), e237–e239. https://doi.org/10.1016/j.nurpra.2017.02.010
Hypertension (High Blood Pressure). (n.d.). NCCIH. https://www.nccih.nih.gov/health/hypertension-highblood-pressure
Hypertension and Psychological Health in the 21st Century - ProQuest . (2018). Www.proquest.com. https://www.proquest.com/openview/e1d9f4e7bbb3d6e50c50d0104a56e59b/1?pqorigsite=gscholar&cbl=237822
Welcome to the Natural Medicines Research Collaboration. (2019). Therapeuticresearch.com. https://naturalmedicines.therapeuticresearch.com
