Assessment and management of patients with hypertension

Omar Alzaabi・2 minutes read

Hypertension management involves lifestyle changes and pharmacological therapy, with a focus on gradual medication initiation and potential combination therapies to reach target blood pressure goals. Nurses play a vital role in assessing risk factors, educating patients, and addressing social and financial barriers to treatment adherence in hypertension care.

Insights

  • Hypertension, defined by systolic pressure >140 and diastolic pressure >90, often lacks symptoms but can lead to severe organ damage if left untreated, making regular blood pressure monitoring crucial for early detection and management.
  • Effective management of hypertension involves a combination of lifestyle modifications like weight loss, dietary changes, and physical activity alongside pharmacological therapy, with initial medication typically starting with low doses of thiazide diuretics and potentially requiring multiple medications like ACE inhibitors and calcium channel blockers, emphasizing the importance of a holistic approach to treatment that addresses both medical and lifestyle factors.

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Recent questions

  • What is hypertension?

    Hypertension is a condition characterized by high blood pressure, with systolic pressure above 140 and diastolic pressure above 90.

  • How is hypertension diagnosed?

    Hypertension diagnosis requires two accurate blood pressure readings.

  • What lifestyle modifications are important for managing hypertension?

    Lifestyle modifications for hypertension management include weight loss, DASH diet, reduced sodium intake, physical activity, and moderate alcohol consumption.

  • What are the types of hypertension?

    Types of hypertension include primary (essential) and secondary.

  • What are the pharmacological therapies for hypertension?

    Pharmacological therapy for hypertension includes diuretics, vasodilators, and beta blockers.

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Summary

00:00

Managing Hypertension: Diagnosis, Treatment, Lifestyle Changes

  • Lecture on assessment and management of hypertension in Chapter 31.
  • Definition of hypertension: systolic pressure >140, diastolic pressure >90.
  • Hypertension diagnosis requires average of two accurate blood pressure readings.
  • Classification of blood pressure: normal, pre-hypertension, stage 1 hypertension, stage 2 hypertension.
  • Hypertension is often asymptomatic, leading to organ damage if untreated.
  • Hypertension is the second leading cause of death globally.
  • Types of hypertension: primary (essential) and secondary.
  • Lifestyle modifications crucial for hypertension management: weight loss, DASH diet, reduced sodium intake, physical activity, moderate alcohol consumption.
  • Pharmacological therapy for hypertension includes diuretics, vasodilators, beta blockers.
  • Initial medication for hypertension often includes thiazide diuretics.

16:31

Managing Hypertension: Medication, Lifestyle, and Complications

  • Low doses of medication are initiated and gradually increased if blood pressure does not reach the target goal, such as starting with hydrochlorothiazide at 12 milligrams and potentially increasing to 25 milligrams if needed.
  • Additional medications may be added if necessary, with multiple medications possibly required to control blood pressure, leading to the use of different combinations like ACE inhibitors, thiazides, and calcium channel blockers.
  • Lifestyle changes are crucial alongside medication to control blood pressure, with nurses engaging in a process that includes taking history and assessments to identify risk factors, potential symptoms, and organ damage related to heart, kidney, or eye problems.
  • Social and financial factors can impact treatment adherence, with some patients facing challenges in affording medication, leading to deficits in knowledge about treatment regimens and disease control, necessitating patient education and support for adherence.
  • Complications of hypertension like myocardial infarction, heart failure, stroke, renal problems, and retinal hemorrhage must be monitored and managed, with a focus on planning and goals for disease understanding, treatment participation, and self-care programs.
  • Hypertension crises are classified as emergencies if blood pressure exceeds 180/120, requiring immediate reduction to prevent organ damage, with hypertensive urgency indicating high blood pressure without immediate organ damage, necessitating differentiation and management through blood pressure reduction and frequent monitoring.
  • Considerations for medication regimen complexity and cost challenges highlight the need for simplification, potentially through mono-therapy like a combination tablet such as amlodipine hydrochloride and an ACE inhibitor, involving family support and education for patient care.
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