NRS-490 EBP Capston Project Paper & Practicum: Treatment of Hypertension

NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension

Hypertension

Hypertension, also known as high blood disease pressure is a serious condition that ultimately results in damaging of blood vessels leaving an individual prone to heart attack, stroke, and other conditions. Various factors increase the likelihood of developing the disease they include obesity, consumption of a lot of salt, diabetes, smoking, and alcohol intake. Globally, hypertension results in the death of millions of people, but with the right administration, the mortality rates can be reduced. Treatment of hypertension is diverse including lifestyle changes and treatment through drug therapy. Lifestyle approach in the treatment of hypertension involves intake of healthy diets, quitting smoking, physical exercise, and reducing alcohol intake. Considering the complexities that surround the treatment and management of hypertension, this paper seeks to demonstrate that it is crucial to incorporate lifestyle modifications alongside medical treatments in the management of high blood pressure. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

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Background of the Problem

Hypertension is a worldwide health issue that afflicts many individuals. The causative factors for the condition can be genetic or acquired through poor lifestyle habits. The disease may also present as a co-morbidity to other illnesses such as diabetes and kidney disease or hypertension may lead to the onset of these diseases. Hence, the problem prevails in a vicious cycle pattern making treatment goals difficult to achieve (Wang, Ning, Yang, Lu, Tu, Jin & … Su, 2014). In addition, the advancement of the food processing industry has immensely contributed to the development of hypertension because of the relatively higher amounts of salts and other harmful food additives in the diets. If left unmanaged, hypertension can lead to the development of co-morbidities such as heart disease, diabetes, and stroke. Blood pressure involves exertion of force on the walls of the blood vessels, with the amount of force exerted dependent on the levels of resistance from the blood vessels and the amount of work done by the heart. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension

Problem Statement

Estimates issued by the World Health Organization indicate that in the United States alone, over 85 million people are suffering from hypertension. In the low and middle-income countries in the world, urbanization has steadily caused an upsurge in the number diagnosed cases of hypertension due to changes in lifestyle habits. Globally, increased blood pressure has been found to cause over 7 million deaths, a figure which accounts for over 12% of the total world deaths. Overall, both men and women develop high blood pressure, although the prevalence rates are higher for men than for women. Therefore, hypertension is a public health concern that has been found to cause the development of cardiovascular disease and stroke (Khdour, Hallak, Shaeen, Jarab & Shahed 2013). NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

A lot of research work has been carried out with the intention of deciphering the etiology of the disease and the best treatment approaches to the problem of hypertension. Although the research efforts have centered on the medical perspectives of treatment, exploration of the role of lifestyle modification as a preventive measure for hypertension needs to be carried out (Khdour, Hallak, Shaeen, Jarab & Shahed 2013). Furthermore, lack of adequate awareness about hypertension on the part of the patient substantially influences the onset of hypertension, and the delayed seeking of treatment for the condition. Also, because of an increase in population and the sharp increase of the geriatric demographic age group, the number of people living with unmanaged hypertension in the world has been on the increase; hence this paper advocates for the use of lifestyle modifications in the management of hypertension among adult males. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

 Purpose of the Change Proposal

Considering the complexities that surround the treatment and management of hypertension, this paper seeks to demonstrate it is crucial to incorporate lifestyle modifications alongside medical treatments in the management of high blood pressure. This is because ideally, lifestyle changes should be considered not only as preventive measures but also as first line treatment options. These adjustments include dietary changes such as consumption of low sodium, high glycemic index foods, and daily intake of 3-5 servings of fruits and vegetables. Physicians and nurses recommend that pre-hypertensive or hypertensive patients engage in physical exercise which includes half an hour of low to moderate intensity aerobic exercise such as swimming, jogging walking or cycling (Nwankwo, Yoon, Burt, & Gu, 2013). In addition, utilizing stress reduction measures significantly assists with blood pressure control. These measures include avoidance of cigarette smoking and alcohol and consumption of unhealthy diets. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

PICOT Statement

To address the problem of hypertension, the following PICOT question was developed: For male grown-ups between the ages of 40 and 70 with hypertension, and with various co-morbidities, will the adjustment in way of life (drawing in routinely in exercise and eating more beneficial and adjusted suppers), contrasted with patients who utilize prescription to treat/deal with their hypertension, help to control their pulse and diminish the danger of creating cardiovascular illnesses in their recuperation period inside a half year? The period will be sufficiently long to make a patient to be capable not to experience the ill effects of hypertension and to likewise lessen the dangers that the people will ordinarily go through. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension. 

Literature Search Strategy Employed

For the search of literature review, the Ebscohost data base search was used. Key words used in the search were hypertension, high blood pressure, and hypertension among males. A total of 25 articles related to hypertension were found and another 13 articles discussing high blood pressure and other morbidities were found. Further, no articles related to the topic of hypertension among males were found in the data base. Of the 38 articles found, those that failed to meet search criteria of hypertension and high blood pressure and lifestyle adjustments were eliminated. A total of three articles were left for the literature review. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

Literature Review

As discussed earlier, the problem of hypertension has a high prevalence in the United States and the world. Wang et al. (2013) assert that high blood pressure is the single most significant risk factor in the development of cardiovascular disease.  The authors further state that low awareness lack of treatment and management leads to an increase in the number of deaths and complications from hypertension. Risk factors such as high body mass index lack of physical exercise and consumption of unhealthy diets cause further problems into an already complex issue.

A National Health and Nutrition Survey reveals that early diagnosis and treatment ensures the prevention of complications of hypertension for instance damage of the arteries and blindness (Nwankwo, Yoon, Burt, & Gu, 2013). However, research by suggests that hypertensive patients may fail to develop signs or symptoms in which case treatment is sought for the eventual complications such as blindness. Lifestyle changes in combination with medication may lower high blood pressure and lead to an improved quality of life for the patient. However, lifestyle modifications alone have been found effective as a first line option treatment for hypertension. These changes include the incorporation 30 minutes of physical activity into the patient’s daily routine. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

Ideally the goal of physical exercise is to assist the patient with weight loss and a reduction of the BMI (Khdour et al., 2013). Dietary adjustments entail intake of low sodium diets, intake of high fiber diets, which includes fruits and vegetables, and consumption of low-fat dairy products. Lifestyle modifications also constitute the avoidance of stress and its causative factors such as smoking and alcohol consumption. Dietary changes may involve the nurse or the nutritionist assist the patient develop a feeding plan which is known as dietary approaches to stop hypertension diet.

Applicable Change Model

For patients suffering from hypertension and other chronic diseases, the Chronic Care Model is an effective organizational strategy to caring for hypertensive patients. I this scenario, the model is applicable because it utilizes evidence based research and creates interactions between an educated patient and a proactive team of health care professionals. Moreover, the system is practical and offers support for the patient in management of hypertension (Davy, Bleasel, Liu, Tchan, Ponniah, & Brown, (2015). NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

Implementation Plan

Following the six components of the Chronic Care Model, the implementation plan will aim to decrease high blood pressure, manage weight, support self-management and decision making that will impact on the overall well-being of the patient. Self-management is critical because it indicates that the patient is in charge of their own health care situation. Applicable changes will be filtered through the components of the Chronic Care Model and tested against evidence-based research to ascertain that they are effective at achieving the goals of blood pressure reduction and weight reduction (Davy, Bleasel, Liu, Tchan, Ponniah, & Brown, (2015).

Potential Barriers to Implementation

Potential barriers to the implementation of the plan include patient apathy and non- adherence to the issues such as physical activity and consumption of healthy diets to achieve the treatment goals of lowering blood pressure and weight reduction (Khatib, 2012). Another key barrier from the patient is an attitude of indifference which may result in the patient viewing the plan as inconsequential and non-contributory to the management of their blood pressure.

Conclusion

As noted, hypertension is among the leading causes of heart attacks, strokes, and other complications. With the right interventions in place, the condition can be managed and treated; hypertension treatment considers two forms of treatment including the use of anti-hypertensive drugs as well as lifestyle modifications. Anti-hypertensive drugs used include diuretics, angiotensin, converting enzymes blockers, beta blockers among others each of the drugs work differently, but all ultimately result in lowering the blood pressure. Therefore, apart from medication, lifestyle changes are also crucial in management and treatment of the disease especially in reducing cardiovascular risks and lowering the blood pressure. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

References

Davy, C., Bleasel, J., Liu, H., Tchan, M., Ponniah, S., & Brown, A. (2015). Effectiveness of chronic care models: Opportunities for improving healthcare practice and health outcomes: A systematic review. BMC Health Services Research, 15, 194. http://doi.org/10.1186/s12913-015-0854-8

Khatib, O. M. (2012). Clinical guideline for the management of hypertension. New York, NY: World Health Organization. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.

Khdour, M., Hallak, H., Shaeen, M., Jarab, A., & Shahed, Q. A. (2013). Prevalence, awareness, treatment and control of hypertension in the Palestinian population. Journal of Human Hypertension, (10), 623. doi:10.1038/jhh.2013.26

Nwankwo, T., Yoon, S. S., Burt, V., Gu, Q. (2013). Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief (133),1-8.

Wang, J., Ning, X., Yang, L., Lu, H., Tu, J., Jin, W., & … Su, T. (2014). Trends of hypertension prevalence, awareness, treatment and control in rural areas of northern China during 1991-2011. Journal of Human Hypertension, 28(1), 25-31. doi:10.1038/jhh.2013.44. NRS-490 EBP Capstone Project Paper & Practicum: Treatment of Hypertension.