Figure 2 lists a number of risk factors that a person may change to reduce his/her risk of developing hypertension and/or to lower his/her blood pressure.
Figure 2: Risk Factors for Hypertension (adapted from Rizzo, Odle & Costello, 2006, Risk Factors section, ¶ 1).
Diagnostic Tests
Sharp (2006), purports that the four goals of evaluation for hypertension include:
1. Identifying lifestyle factors that contribute to elevated blood pressure and increased risk for cardiovascular disease,
2. assessing linking modifiable cardiovascular risk factors,
3. assessing for target organ disease, and
4. determining whether a secondary root exists for the elevation of the person's blood pressure (Sharp, 2006).
The instrument for measuring blood pressure, a sphygmomanometer, consists of a cloth-covered rubber cuff, which is wrapped around the upper arm and inflated. Rizzo, Odle and Costello (2006) explain the process:
When the cuff is inflated, an artery in the arm is squeezed to momentarily stop the flow of blood. Then, the air is let out of the cuff while a stethoscope placed over the artery is used to detect the sound of the blood spurting back through the artery. This first sound is the systolic pressure, the pressure when the heart beats. The last sound heard as the rest of the air is released is the diastolic pressure, the pressure between heartbeats. Both sounds are recorded on the mercury gauge on the sphygmomanometer (Rizzo, Odle & Costello, 2006, Diagnosis section, ¶ 2).
To evaluate hypertension, the typical physical examination includes:
Medical and Family History
Physical Examination
Ophthalmoscopy: Examination of the Blood Vessels in the Eye
Blood and Urine Tests. (Rizzo, Odle & Costello, 2006, Diagnosis section, ¶ 4)
When evaluating a person for hypertension, the physician may examine the blood vessels in the eyes with an ophthalmoscope, to see if any hemorrhages, narrowing, or thickening exists in the blood vessels. The physician may also perform blood and urine to detect the presence of particular substances that may indicate an underlying condition that may factor into the hypertension. Generally, along with the physical examination and medical history the physician performs, blood tests and urine tests prove sufficient to make the diagnosis of hypertension. At times, however, other tests may be necessary to rule out other medical conditions or to assess possible damage from hypertension and/or its treatment. Figure 3 lists a number of tests the physician may perform:
Figure 3: Common Test Utilized for Hypertension (adapted from Rizzo, Odle & Costello, 2006, Diagnosis section, ¶ 9).
Medical or Nursing Therapies
No cure currently exists for primary hypertension, however, the correct treatment can almost always blood pressure be lowered. In treating hypertension, the physician attempts to "lower blood pressure to levels that will prevent heart disease and other complications of hypertension that could manifest in adulthood. In secondary hypertension, the disease that is responsible for the hypertension is treated in addition to the hypertension itself" (Rizzo, Odle & Costello, 2006, Treatment section, ¶ 1). When the underlying disorder is successfully treated, the secondary hypertension may simultaneously be cured.
Some treatments for hypertension considered alternative and complementary therapy, may include approaches not considered as mainstream of traditional health care. Acupuncture and biofeedback training, as well as yoga, tai chi, meditation, guided imagery, and relaxation training denote a few techniques to induce relaxation and reduce stress, and as a result may prove helpful in controlling blood pressure. "Dietary supplements, including garlic, fish oil (omega-3 fatty acids), L-arginine, soy, coenzyme Q10, phytosterols, and chelation therapy may be beneficial, but the exact nature of their effects on blood pressure is unknown" (Rizzo, Odle & Costello, 2006, Alternative Treatment section, ¶ 3). Little scientific evidence, albeit, exists to confirm that these type therapies do in fact lower blood pressure and/or prevent complications that accompany high blood pressure
Commonly Prescribed Medication
Diuretics, the oldest, least expensive class of drugs used to treat hypertension, "water pills," help the kidneys eliminate sodium and water from the body, the article, "Medications for treating hypertension," (2007) explains. When one cannot control his blood pressure by adopting healthier habits, "such as limiting salt, increasing exercise, and quitting smoking - then it's time for medications" (Medications for & #8230;2007). No one particular medication, however, suits each individual. The Mayo Clinic staff (2009) reports that a physician may initially prescribe a diuretic to treat hypertension as these medications flush excess water and sodium from the body; in turn lowering blood pressure. Along with lifestyle changes, this may control the individual's blood pressure.
Typical Dose
Vergara, Wang and Banfi (2008) report that...
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