Gurnee is a village in the Lakeside state of Illinois. As of 2010, the population stood at just over 31000 people. Considered as part of the Chicago metropolitan area, it is on the border to the city of Waukegan. The village’s greatest attraction is the Six Flags Great America as well as the Gurnee Mills. Both of these locations receive well over 26 million people annually. The village covers a geographic area of slightly more than 13.5 square miles, 99.5% which is land and 0.5% which is water. The village is found on the banks of the Des Plaines River and cut by the Interstate 94, thereby dividing the village into the East and West.
Regarding demographics, the village’s population has increased by 8.5% from the 2000 census. The population density stood at over 2,300 people per square mile with just over 12,000 housing units. The racial make-up was largely white, consisting 73.3% white, 11.6% Asian, 7.8% African American and 0.03% Native American. Other races consisted the remaining 3.5%, while 3.2% were from two or more racial backgrounds. Additionally, up to 42.3% of the households had children under the age of 18 living with them, while 63% were couples living together. The average family size was 3.25 people, while the median household income was $85,421 per annum.
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Hypertension in Gurnee Village
The prevalence of hypertension among village adults is an area that has been widely researched across different continents including Africa and Asia. Of necessity, it becomes critical to determine the prevalence of hypertension in Gurnee to effectively consider best practice solutions to managing the disease among the population. The prevalence of hypertension in Gurnee shall be considered as prevalence in the larger Lake County, where it is located. Within Lake County, cardiovascular diseases, specifically hypertension affect over one third of the adult population. In fact, adults are more likely to be diagnosed with pre-diabetes in this county compared to Illinois as the state (14% versus 6.9% respectively). Among other diseases, which have high prevalence is asthma, arthritis and hypertension, which takes the lead with 35% of all death, illness and injury cases being reported as a result of hypertension. As a result, the hypertension problem is a real problem in Gurnee village and Lake County as a whole.
Pathophysiology of Hypertension
Approximately 20 million adults are affected by hypertension in the United States. It is a major risk factor for kidney failure, vascular disease and stroke. It is characterized by high systolic blood pressure of over 140 mmHg or diastolic blood pressure of 90 mmHg or more (Katakam, Brukamp, & Townsend, 2008). Hypertension could develop from primary causes such as environmental and genetic causes, or have secondary causes such as endocrine, vascular or renal causes. However, primary causes account for the majority of hypertensive cases (90-95%). The diagnosis is done through an accurate measure of the patient’s blood pressure, performing a physical examination of the patient and obtaining a medical history.
Hypertension is caused by an elevation in blood pressure, resulting in long-term damage of end-organs and subsequent mortality. Blood pressure is a combination of two measures, namely: vascular resistance and cardiac output. Therefore, hypertensive patients may have either exceptionally high cardiac output or significantly high vascular resistance. In younger patients, the former is normally the case, while in older patients the latter is most likely cause.
Management of Hypertension
Different guidelines exist for the effective management of hypertension. Among some of the organizations involved in making such recommendations include the American Diabetes Associate (ADA), the American Heart Association (AHA) and the JNC. Their first step towards managing hypertension is lifestyle changes.
The JNC has made recommendations regarding lifestyle changes, where two or more changes achieve high effectiveness over time. These include weight loss – where every ten kilograms of weight loss could result in the reduction of systolic blood pressure (SBP) by 5-20 mmHg, limited alcohol intake of one pound for men and half a pound for women, thereby effectively reducing between 2-4 mmHg of SBP. Again, sodium intake should equally be reduced to no more than 6 grams of sodium chloride effectively reducing between 2-8 mmHg SBP. On the positive additions to lifestyle changes, the patient should maintain an adequate intake of potassium, calcium and magnesium for their health in general, while engaging in at least 30 minutes of aerobic exercise for most days of the week, thereby reducing SBP by 4-9 mmHg (Weber, et al., 2014).
In the same vein, the AHA recommends a diet high in potassium and low in sodium. This should be complimented with the intake of fruits and vegetables and limited amounts of low-fat dairy products. Again, increased physical activity which extends for at least 30 minutes on a daily basis is required, whereas weight loss is necessary for overweight and obese persons (Whelton, et al., 2012). The European Society of Hypertension holds similar views, requiring a low-sodium diet as well as a reduction of one’s body mass index to the recommended 25kg/sq. m alongside an ideal waist circumference of 102 cm in males and 88 cm in females (James, et al., 2014).
Again, additional options are available where lifestyle changes alone are insufficient to occasion the necessary changes to reduced hypertension. Several drug options are available for treatment and management of hypertension. For non-black populations, angiotensin-converting enzyme (ACE) inhibitors or a calcium channel blocker (CCB) are preferred agents. Nevertheless, CCBs are best suited for black populations. Nevertheless, the recommendations are not carved in stone. ACEs and ARBs may be used in the treatment of black hypertensive patients since many times, several drugs are required to achieve optimal BP control. Be it as it may, other factors are in play when determining which drugs would be most suitable for use in treating and managing hypertension, including the risk of congestive heart failure, kidney disease, diabetes and ischemic heart disease. Again, drug contraindications and intolerability is also considered prior to administering the drugs. As a result, drug class recommendations are offered in the case where multiple factors are play during drug administration for hypertensive cases. These include beta-blockers and ACE inhibitors where there is risk of heart failure and following myocardial infarctions (Agarwal, et al., 2014). An ACE inhibitor or ARB could be administered in the case of diabetes of chronic kidney disease (Chobanian, et al., 2003).
Conclusively, the management of hypertension is an affair largely requiring the change of lifestyle habits. From the recommendations sampled by the vascular health organizations, a key consideration to the treatment and management of hypertension is through the change of normal lifestyle habits that occasion risk. Moreover, up to 95% of all hypertension cases are primarily caused, that is either genetically or environmentally. This means that if such factors could be reduced through healthy lifestyle changes, it is possible to immensely reduce the frequency of occurrence of the disease in Lake County, and specifically, Gurnee Village.
References
Agarwal, R., Flynn, J., Pogue, V., Rahman, M., Reisin, E., & Weir, M. R. (2014). Assessment and management of hypertension in patients on dialysis. Journal of the American Society of Nephrology , ASN-2013060601.
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo Jr, J. L., & Roccella, E. J. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama, 289(19) , 2560-2571.
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., & Smith, S. C. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5) , 507-520.
Katakam, R., Brukamp, K., & Townsend, R. R. (2008). What is the proper workup of a patient with hypertension? Cleveland Clinic journal of medicine, 75(9) , 663-672.
Weber, M. A., Schiffrin, E. L., White, W. B., Mann, S., Lindholm, L. H., Kenerson, J. G., & Cohen, D. L. (2014). Clinical practice guidelines for the management of hypertension in the community. The journal of clinical hypertension, 16(1) , 14-26.
Whelton, P. K., Appel, L. J., Sacco, R. L., Anderson, C. A., Antman, E. M., Campbell, N., & Labarthe, D. R. (2012). Sodium, blood pressure, and cardiovascular disease. Circulation, 126(24) , 2880-2889.
