Introduction
Hypertension is chronically high blood pressure and is one of the world’s common medical problems. People with hypertension may not experience any symptoms until the disease progresses to the advanced stage. High blood pressure is the leading cause of heart attack, stroke and kidney problems. It occurs when the pressure of the blood is high as it flows against the artery walls. Blood pressure can be determined by the amount of blood the heart pumps and the level of resistance to the flow of blood across the arteries.
Hypertension develops gradually over many years until it reaches a level that can cause a health risk. Hypertension is usually classified into stages depending on the pressure of the blood. In the stage one hypertension, the systolic pressure 130 to 139 mmHg or diastolic pressure 80 to 89 mmHg ( Thomopoulos, Parati & Zanchetti, 2016 ). Stage two hypertension, on the other hand, has a Systolic pressure greater than 139 mmHg or pressure diastolic greater than 89 mmHg. Over the years, hypertension has continued to cause serious health problems both in the United States and globally. The disease which is mainly common in adults and the risks increases with age. Constant blood pressure checkup is required for early detection and management before the disease can progress to an advanced life-threatening stage.
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History and Significance
History of hypertension can be dated back to the work of William Harvey, a physician between 1578 and 1657. In his book, William described the circulation of blood and the cardiovascular system. The first ever published measurement of blood pressure occurred in 1733, and this marked the begging of what is currently known as hypertension ( Thomopoulos, Parati &Zanchetti, 2017 ). The history of hypertension can, however, be traced back to the ancient Chinese and Indian medicine. The study of the cardiovascular system led to what was called a hard pulse, a term that can qualify for a modern word for hypertension. Mentioning the history of hypertension without referring to Akbar Mahomed is, however, an incomplete history. Working at Guy hospital in London in the late 19th century, physician Frederick Akbar first described the conditions which later became to be known as essential hypertension ( Rosenthal, 2014 ). Akbar described that high blood pressure can exist in healthy individuals and that the risks increase with age. He further discovered that high blood pressure could cause health problems such as heart and kidney disease.
Hypertension has also undergone a lot of transition since the historical times concerning its treatment. Historically, the treatment of the disease involved reducing the quantity of blood by applying leeches. Over time, many new treatment methods have been devised with some proving to be ineffective while others being ineffective. Hypertension has had several health effects on the Americans as a significant population of adults has been reported to have the disease ( Bhansali et al., 2015 ). Serious health effects include stroke and heart attack. This has had severe health problems to the Americans, with some people have lost their lives when the disease gets to the advanced stage.
Symptoms
Even though hypertension may not show any symptoms at an early stage, advancement into late stages can come with a variety of symptoms. One of the most common symptoms of high blood pressure is a recurrent headache. People with hypertension experience a series of headaches which come and disappear after a while. The worsening of the headache increases when the pressure of the blood goes beyond the normal and can be mild, moderate or even severe( Nwankwo et al., 2013 ). Another common symptom of high blood pressure is dizziness. Dizziness is however common in people who are already under medication and may not last for long. People with hypertension may also experience shortness of breath because of the effect it has on the heart and lungs. Nosebleeds can also accompany hypertension and may reoccur more frequently. When hypertension goes untreated, it can lead to severe complications which can include organ damage and other serious health problems ( Nwankwo et al., 2013 ).
A less common symptom known as hypertensive urgency can occur when hypertension is not treated. This comes with serious complications and can lead to many organs of the body getting damaged as a result of the force of the blood. Family history is also related to the chance of one developing high blood pressure. Family members share genes, behaviors, environment, and lifestyle and this affects their ability to develop high blood pressure if one member of the family had the disease ( Daskalopoulou et al., 2015). People with the family history of high blood pressure share a common environment and other potential factors and are more likely to develop the disease. Heredity combined with risky lifestyle increase the chances of an individual developing high blood pressure. The risky lifestyles include smoking and unhealthy eating which can lead to complications and enhance the chances of developing hypertension.
Risk Factors
Several factors exist that increases the risk of an individual developing high blood pressure. Being overweight is one of the risk factors that can increase the chances of one developing hypertension. The amount of blood needed to be supplied across the body increases with an increase in the body weight. As a large volume of oxygen is needed to supply oxygen to the body tissues, more pressure within the arteries is needed to pump that blood ( Rosendorff et al., 2015 ). This increases the chance of an individual developing high blood pressure. Another risk factor for hypertension is too much sodium in the diet. Excess sodium can cause the body to retain fluid while also making the arteries to constrict thus increasing the chances of developing high blood pressure. Excessive consumption of alcohol can also increase the chance of an individual developing high blood pressure. Too much alcohol can activate the adrenergic nervous system, cause constriction of the blood vessels and increase the pressure at which the blood flows through the body ( Hicken et al., 2014 ). High levels of stress can also put an individual at the risk of developing hypertension. However, stress causes a dramatic but temporary blood pressure which can be controlled by relaxing and avoiding high blood pressure.
Lack of physical exercise can also put a person at the risk of developing hypertension. Lack of physical exercise is associated with increased body weight which in itself is a risk factor for developing hypertension. Physical exercise increases the flow of blood through the arteries which then leads to the release of hormones that relax the blood vessels lowering the blood pressure ( Mozaffarian et al., 2015 ). Age is another risk factor in the development of high blood pressure. As people grow old, a combination of unhealthy lifestyles such as smoking and other potential factors can increase the chance of developing high blood pressure. Hypertension is more prevalent in adults than in children and youth. Family history also plays a role in the ability of an individual to develop hypertension. If a member of a family had high blood pressure, there is an increased risk that a member from that family will develop the disease.
Prevalence
Hypertension is the leading cause of cardiovascular diseases globally. According to the American Heart Association, an estimated number of at least 100 million Americans have high blood pressure ( Moyer, 2013 ). With the increase in the number of aging population, it is estimated that number will increase in the next five years. Between 2005 and 2015, the death rates due to high blood pressure increased by 11% to hit 38% ( Sorlie et al., 2016 ). Nearly a third of the world’s adult population is affected by high blood pressure making it a global threat to health. A report by the Centers for Disease Control and Prevention, one person in every three has high blood pressure, and this is the leading cause of stroke, kidney failure, and heart attack. About 30% of the cases of high blood pressure is attributed to obesity ( Allison, Edlen-Nezin & Clay 2014). West Virginia is the leading in the hypertension prevalence with a rate of 43.5%. The prevalence of hypertension increases with age as the majority of the affected population are adults age 30 and above. The most affected population are adults who are over 60 years with the prevalence rate being at 63% ( Sorlie et al., 2016).
The overall prevalence of hypertension in the United States is high among men compared to women. With an average rate of 29% prevalence in 2016, the rate is high in men at 30.2% followed by women at 27.7% ( Sorlie et al., 2016). The hypertension prevalence is also affected by race, with Hispanic whites leading at 27.8% followed by Asians at 25% ( Sorlie et al., 2016). At least 500 Americans die every day due to high blood pressure and the related health conditions. Statistics further show that 20% of Americans with hypertension do not know that they have it, while more than 40% of the affected population are under medication to control the disease ( Sorlie et al., 2016). Out of the people with hypertension, 77% are reported to have a stroke while 74% have heart failure ( Sorlie et al., 2016). The number of global deaths due to high blood pressure has remained relatively high even though some nations have witnessed a small drop in the number.
Role of sociological Factors
Environmental and social factors play a vital role in the development of hypertension among individuals. There is a disparity in incidence and prevalence of hypertension with African Americans being the most affected ( Dolezsar et al., 2014 ). Factors such as social trauma play a significant role in the development of hypertension. Social trauma occurs when a group of people experiences racial discrimination in their everyday life. The relationship between hypertension and social trauma is that it can cause stress and depression which is a risk factor for the development of high blood pressure. Behavioral factors also play a role in the prevalence of high blood pressure in society. Behavioral factors such as excessive drinking and smoking only add the risks of an individual developing high blood pressure. Economic and social deprivation that result due to racial discrimination can lead to more stress thus the risks of developing hypertension ( Dolezsar et al., 2014 ).
Hypertension costs the United States at least $47 billion in direct medical expenses annually. When people are sick, they are unable to produce this $3.5 billion is lost each year on productivity. The costs in the health care services, medication and missed days of work due to high blood pressure are $131 billion ( Yang, Boen & Mullan , 2015). This statistics shows the serious financial effects that hypertension has in the community. A lot of money goes to the medication and treatment of individuals with high blood pressure while at the same time there is lost production thus slowing down economic growth.
Treatment
Hypertension patients who are at a lower risk of developing other health problems are usually advised to develop a lifestyle change. The lifestyle changes can include reducing the amount of salt taken eating a balanced diet, avoiding too many fats, engaging in physical exercise to keep the right body weight ( Centers for Disease Control and Prevention, 2013 ). Others can also involve avoiding stress and living positively, avoid smoking and drinking and taking less caffeine. Cutting on these activities can lead to healthy living. However, people at risk of developing other health complications can be given certain medications to control their condition. Patients under the age of 55 years can be offered with an ACE inhibitor to help manage the blood pressure ( Centers for Disease Control and Prevention , 2013). People over 55 years can be provided with calcium channel blocker. Depending on the advice from the doctor, hypertension patients may be recommended to take medication for life and avoid certain risky lifestyle.
Public Health Initiatives
One initiative that has been launch to help solve the health problem of hypertension is the Million Hearts Hypertension Educational Program. The Center for Disease Control and Prevention launched a program called “Team up. Pressure Down,” an initiative aimed at helping Americans keep their blood pressure under control ( Giberson, 2013 ). Working with the pharmacists, the program includes educational videos and blood pressure control journal used to teach people how to manage blood pressure. It is part of the Million Hearts health education initiative that was introduced by CDC and the practicing pharmacists with the goal of preventing heart attack among people with high blood pressure ( Giberson , 2013). Having noticed that at least 30 million Americans with hypertension do not know how to manage and control pressure. The initiative has helped teach many people how to control their pressure, and as a result, most high blood pressure patients who have participated in the program have mentioned that they have benefited.
Another program that was developed by CDC is the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN). This initiative was created to help the women, especially the low income and the uninsured to reduce the risks of hypertension and heart diseases and to live a healthy lifestyle ( Homan, McBride & Yun , 2014). The programs conduct screening for women between 40 and 64 years and promote healthy behavior that reduces the risks of hypertension, stroke and heart attack. It has helped many women change their lifestyle and manage high blood pressure risks.
Conclusion
Hypertension continues to remain one of the most problematic diseases globally. With millions of people affected, high blood pressure is the leading cause of heart attacks and stroke globally. With an unhealthy lifestyle being one of the causes of the disease, millions of people who are overweight and engage in behaviors such as excessive drinking and smoking have become the target for high blood pressure. Symptoms may not appear at the early stages, but at advanced levels, serious symptoms such as dizziness and headache may appear. Treatment usually requires a change in the lifestyle and adopt a healthy living in addition to other medications such as ACE inhibitors among other drugs. With the rising health effect of hypertension, health agencies such as CDC has launched various programs to help people control and manage hypertension and prevent heart problems. Even though high blood pressure has been controlled in the last few years, it remains a serious health problem that needs serious measures to address.
Public Health Program
The proposed public health program that can be used to help manage and control hypertension is to provide a community-based education program that aims at promoting awareness to the members of the public. Awareness of the risk factors of high blood pressure and other ways to live healthy can help promote good health and prevent the increasing incidences of high blood pressure. Community-based education can also promote awareness to people who are already affected on ways to live positively and manage the condition. Among the areas of concern can be a reduction in smoking and alcohol consumption, giving tips on how to lose weight and the importance of having a balanced diet. These can help the public understand ways to live a healthy life and avoid incidences of hypertension and heart attack.
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