Hypertension has gained popularity as one of the most prevalent medical conditions all over the globe. Hypertension is a condition where the blood pressure is too high on the artery walls, usually 140/90 mmHg and above. Notably, this condition is the primary cause of fatal health conditions: kidney failure, stroke, and cardiovascular health problems. Notably, unmanaged hypertension results in 7.5 billion deaths worldwide per year (Leng et al., 2017). A question then arises: How can hypertension be treated and managed to avoid adverse repercussions? Hypertension can be treated and managed through various approaches based on the medical condition of a patient, different stages of hypertension, and the severity of hypertension.
The medical condition of a patient is essential in determining the course of hypertension treatment. Patients with different medical conditions require different approaches to treatment. A patient with a high risk of heart failure, the optimal Blood pressure should be aimed to be below 130/80 mmHg. Therefore these patients and the ones who are already suffering from Heart failure with reduced injection fraction should receive Guideline directed management prescription in a continuous and balanced measure to attain a blood pressure that is below 130/80 mmHg. The nondihydropyridine calcium channels blockers (CCBs) are not recommended for patients with heart failure and reduced injection fraction because they do not provide functional or mortality benefit and may instead worsen the situation. In clinical history assessment, it is necessary to ask the patient about cardiovascular health issues as it tends to influence the choice of treatment course for hypertension (Weber et al., 2014). Pregnant Hypertensive women should not be treated with ACEIs, ARBs, or direct renin inhibitors. It is crucial to consider the medical condition of a patient before administering a treatment course.
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Patients that are presented with stage one hypertension or elevated blood pressure are required to take necessary measures to modify their lifestyle. In this stage, the blood pressure tends to be above 120/80 mmHg to 159/99 mmHg. Taking the steps required at this stage is necessary because the patient is at risk of developing hypertension (Parati et al., 2014). Patients presented in stage 1 hypertension with an estimated ten-year atherosclerotic cardiovascular disease (ASCVD) risks below ten percent should be treated without pharmacologic interventions. They should be advised to adopt healthy lifestyles with a three to six-month evaluation. In case the healthy lifestyle measures incorporated fail to lower the blood pressure after twelve months, pharmacologic therapy should be introduced. Those with ten years of ASCVD risks above 10% should be prescribed antihypertensive drug therapy in conjunction with non-pharmacological therapies and blood pressure evaluations every month. The lifestyle modification approaches prescribed in this stage include Nutritional therapy, stress management, physical activity, and tobacco avoidance, and minimized alcohol consumption— adoption to healthy lifestyle results in manageable hypertension conditions.
In the case of hypertension crisis, specific and urgent measures should be adhered to save the life of a patient. In this stage, there is a high elevated blood pressure with fatal outcomes if fundamental approaches are not incorporated. The blood pressure tends to be above 180/120 mmHg. This may result in damaged blood vessels, internal organs, or stroke (Weber et al., 2014). Hypertensive patients in this stage should be admitted to the Intensive Care Unit for continuous monitoring of blood pressure and target organ as they continue to receive parenteral administration of appropriate drugs. Patients who develop conditions like aortic dissection, severe preeclampsia or eclampsia, the systolic blood pressure should be lowered to 140 mmHg in the first hour. However, in patients who do not suffer the above conditions, the systolic blood pressure should be reduced to 25% during the first hour. When the patient is clinically stable, the blood pressure is lowered to 160/100 mmHg. Later the BP should be monitored to normal range within 24-48 hours. Urgent and necessary measures are critical in this stage as they can save a life.
In conclusion, hypertension is treated and managed through different approaches based on the medical condition of a patient, different stages of hypertension, and its severity. The medical condition of the patient is essential in determining the course of treatment. The patients in stage 1 hypertension or elevated blood pressure are required to take necessary measures to modify their lifestyle. In the case of hypertension crisis, specific and urgent measures should be taken to save the life of a patient. Hypertension is a medical condition that requires a different treatment approach for different people based on their condition, the stage they are in, and the severity of their condition.
References
Leung, A. A., Daskalopoulou, S. S., Dasgupta, K., McBrien, K., Butalia, S., Zarnke, K. B., & Gelfer, M. (2017). Hypertension Canada's 2017 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Canadian Journal of Cardiology , 33 (5), 557-576.
Parati, G., Stergiou, G., O’Brien, E., Asmar, R., Beilin, L., Bilo, G., & Fagard, R. (2014). European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. Journal of hypertension , 32 (7), 1359-1366.
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: a statement by the American Society of Hypertension and the International Society of Hypertension. The journal of clinical hypertension , 16 (1), 14-26 .
