I chose Hypertension (HBP) as my
research paper topic because I am a young, African American male that was
diagnosed with this medical condition in September 2015. Unfortunately, HBP is known as the silent
killer because people are unaware that they have it. What made me go to the
hospital was one day I was driving to work, and I started to feel dizzy and my
vision was blurry. This was a very scary and eye-opening experience because I
knew something was wrong, however, I never thought that it could be
Hypertension. I went to my Primary Care Physician who completed an exam and
then took my blood pressure. I found out that my reading was 180/100 MMhg. I
came to the realization that I must make life changes to be on the road to
better health. I started to diet, exercise, and accept my reality that I now
live with Hypertension, which in turn allowed me not only to lose close to 40
pounds, but maintain a steady, normal blood pressure with medication. My mother
and her siblings all have Hypertension. They never watched what they consumed
into their bodies as nutrition, which in turn lead to obesity for many of them.
Researchers suggest that unequal social factors and environmental exposures
experienced by blacks/whites contribute substantially to racial ethnic
disparities in health. I believe
education and awareness is the key in minimizing and preventing onset of
medical conditions, at the same time allowing the individual to be more reactive
to seeking medical attention before potential complications arise.
Hypertension or (HBP) for short, may be considered as one of the most
common cardiovascular diseases to date and affects African American adults more
than any other ethnic groups in the United States (Coulon, Wilson, 2015). There
are many factors that place individuals at increased risk for Hypertension,
such as obesity, stress, smoking, alcohol abuse and increased sodium intake
(Sherwood, 2016, p.369). Hypertension is the buildup force of blood against the
artery wall at the moment the heart pumps blood into the vessels. There are
many types of blood pressure, however two common types. Primary or Essential Hypertension is when the
underlying cause is unknown, accounts for 90% of cases, whereas Secondary
Hypertension is when the condition is relative to a primary cause and accounts
for about 10% of cases (Sherwood, 2016, p. 369).
Elevated blood pressure begins at
the cellular level within the walls of blood vessels, in which it primarily
targets and affects the function of endothelial and vascular smooth muscle
cells (Sherwood, 2016, p.340). Endothelial
cells line the blood vessels throughout the body and assist with the transport
of blood and other materials in the bloodstream through other parts of the
body. The smooth muscle cells assist with regulating the flow of blood
throughout the body in addition to blood volume and blood vessel resistance. If
an abnormality is noted to the endothelial and smooth muscle cells, it can
cause dysfunction to the blood vessels that will affect both blood volume, cardiac
output, peripheral vascular resistance and blood pressure.
The arteries are the largest blood
vessels in the body that carry blood from the heart to organs and muscles in
the body. The arteries also regulate the flow of the blood as the heart pushes
blood against the artery wall. The
normal relaxation and recoil of the blood vessels is considered blood pressure.
What makes blood pressure high is when the arteries become thick due to
increased pressure in the artery wall due to the force of blood. The vessels
create less space for blood to travel normally through the body’s systems. This
in turn can cause a great force of pressure against the blood vessels. The more
force against the artery wall due to thickening of the blood vessels, the blood
pressure may be elevated. HBP can cause the blood vessels to become weakened or
burst due to increased pressure over a period. The amount of excess pressure
could prevent blood, energy, and oxygen to an affected area, causing heart
attacks or stroke (Sherwood, 2016, p.337-342).
Blood pressure readings are
performed with the use of a stethoscope determined by two numbers (Systolic and
Diastolic). The systolic reading is the first beat heard with the stethoscope
and refers to the amount of pressure in the vessels during heart muscle
contraction. The diastolic reading is the last sound heard with the stethoscope
and is measured when your heart is resting between beats. High blood pressure
means that the heart is working extremely hard to pump blood to the systemic
systems. The normal blood pressure reading range is 90/60 to 120/80. Pre-
Hypertension values range between 121-139/81-89 and Hypertension is any value over
140/90 (Sherwood, 2016, p. 374).
Blood pumps within the heart and sends the blood, oxygen, energy, and
nutrients to other parts of the body. The blood volume pressure builds up in
the blood vessels when the heart contracts. The pressure builds up in the blood
vessels and relax between heart beats. The blood vessels normally stretch and
recoil during contraction (Sherwood, 2016, p. 341). In Hypertension, the
vessels are unable to stretch and recoil due to trauma of the vessels, which in
turn may lead to organ failure, CVA and Heart Attack.
Our body maintains normal function through a process called homeostasis.
Homeostasis is how our body can maintain an internal atmosphere despite what
may be going on around it. In
Hypertension, there is an imbalance between sodium and water which cause the
blood pressure to be high. Sodium is one of the most abundant extracellular
cations and is pivotal in determining fluid balance (Sebastiano, Bianchetti,
Simonetti, 2014). Sodium assists the kidneys to retain water and is important
in maintaining circulation, blood pressure and assisting the heart in pumping
blood throughout the body. The kidneys regulate the amount of salt in the body
and circulating in the blood. The more sodium detected, the more the kidneys
will filter out more water to excrete the salt in urination. The less salt
detected, the filters will close and retain more salt. Water follows salt by
way of osmosis, meaning that the water, which is less concentrated will follow
the path to the more concentrated pathway, meaning the sodium.
The Autonomic Nervous System and Peripheral Nervous System regulate
blood pressure by increasing and decreasing blood pressure when abnormalities
are noted. The Sympathetic Nervous System stimulate cardiac output by
increasing heart rate and contractility. The Parasympathetic Nervous System
slows down cardiac output by decreasing heart rate (Sherwood, 2016, p. 368).
The Renin- Angiotensin System or (RAAS), is the most important and best-known
hormonal system involved in regulating sodium.
The RAAS system ultimately increase sodium reabsorption by way of renin.
Renin acts as an enzyme to activate angiotensinogen into angiotensin 1 from the
liver. Angiotensin 1 then converts to angiotensin 2 via angiotensin converting
enzyme. Angiotensin 2 constricts blood vessels throughout the body, which
increases blood pressure and blood flow resistance. Angiotensin 2 also
constricts blood vessels which in turn will minimize amount of blood and water
excreted from the kidneys, which will both increase blood volume and blood pressure.
Angiotensin 2 is the main source for secreting aldosterone from the adrenal
cortex, which is a hormone that decreases urinary output by increased retention
of water and sodium by the kidneys (Sherwood, 2016, p.508).
for Hypertension can involve many factors. There are some non-pharmacological
interventions to consider, including diet, exercise, no smoking and low sodium
intake. Experts recommends a diet of sodium intake no more than 1500mg daily,
however many people consume over twice as much due to processed, pre- packaged
and restaurant foods (Sherwood, 2016, p. 373). There are many medications that
can be used in addition to other interventions that will help to lower and
control high blood pressure. Calcium Channel Blockers, such as
Amlodipine(Norvasc), relax the blood vessel wall, minimizing the force of the
blood volume and lowering blood pressure (Kluwer, 2017, p.44). Thiazide diuretics,
such as Furosemide (Lasix), assist in removing unwanted fluid from the body and
lowering blood pressure (Kluwer, 2017, p.47).
of Hypertension can be life threatening. There are 5 most common complications
of untreated Hypertension. 1.) Left Ventricular Hypertrophy is when the heart
muscle thickens to pump normal blood volume against elevated pressure. The
later stages can cause systolic heart failure as the heart weakens and becomes
unable to pump due to increased arterial pressure. 2.) CVA caused by rupture in
brain blood vessels. 3.) Myocardial Infarction caused by rupture of coronary
vessels. 4.) Kidney failure caused by progressive impaired blood flow caused by
the damage to renal blood vessels. 5.) Loss of vision due to retinal eye blood
vessel damage (Sherwood, 2016, p.369-374).
The drug that I am currently taking
to treat and control my Hypertension is called Metoprolol. Metoprolol is a Beta
Blocker in which it decreases the workload of the heart, which in turn will
decrease the amount of pressure to the blood vessels, reduce blood volume and
lower the blood pressure. Since taking this medication, my blood pressure is
now controlled in addition to diet and exercise (Kluwer, 2017, p.43).
In closing I would state that Hypertension is one of many conditions
that affects our society today. I believe knowledge is power. The more we know,
the further we can grow and raise awareness to minimize medical conditions from
occurring more often.