What is Hypertension?

Hypertension is very common in Americans and if left untreated can lead to a multitude of other very serious health concerns. Many people with hypertension might be completely unaware of their condition or simply do not have it under control. Which is why patient education on what hypertension is, its causes, and its treatment is so important.

Hypertension, most simply put is high blood pressure. Meaning that the pressure exerted with each beat of the heart on the arteries is greater than expected. “A normal blood pressure level” according to the Center for Disease Control and Prevention, aka the CDC, “is less than 120/80 mmHg.” Therefore, anything above 120/80 is considered either prehypertension or hypertension and needs to be monitored and treated accordingly.

Causes

In most cases, there is no direct cause of high blood pressure indicating Primary Hypertension, also known as Essential Hypertension. In other instances, there is a direct correlation between high blood pressure and another disease, such as kidney disease or an adverse effect of a medication. When the cause is known, it is then referred to as Secondary Hypertension.

Prehypertension

If your blood pressure is greater than 120/80 but less than 140/90, then you are considered prehypertensive. For instance, a patient with a blood pressure of 138/87 would fall under this prehypertensive category and need education on lifestyle changes to prevent hypertension. See Patient Education – Lifestyle Changes below for more information.

Risk Factors

Risk factors for Primary, aka Essential Hypertension include:

Family history
Poor lifestyle choices (poor nutrition, smoking, being overweight, excessive alcohol use)
Sedentary lifestyle
High cholesterol
Stress
Being greater than 60 years old
African American

Secondary Hypertension risk factors include:

Diabetes
Kidney disease
Pregnancy
Medications

For more information on diabetes, visit Nursing Fundamentals: A Guide to Diabetes.

Signs & Symptoms

Oftentimes patients who present with hypertension are asymptomatic, meaning they do not have any symptoms. This is especially common if it is a new occurrence or if the blood pressure is only slightly elevated. If the patient is symptomatic, they may have a headache, feel dizzy or faint, have vision changes, or feel flush in the face.

Patient Education – Lifestyle Changes

For patients with prehypertension, or even a family history of hypertension, certain lifestyle changes are important to help prevent and control the development of high blood pressure. Educate your patients to monitor their blood pressure at home and keep record. This way they can easily notice a change in their blood pressure and notify their provider promptly.

In addition to monitoring, educate your patients on the importance of eating healthy and exercising daily. Encourage smoking cessation and weight management. You can even put in an order for a nutritionist to come speak with your patient if you think that would be beneficial. Lastly, reinforce a lifestyle of stress reduction. Of course a certain level of stress is inevitable, but encourage things like meditation, yoga, or scheduled massages to help with this!

Medications

Sometimes even with extensive lifestyle changes the blood pressure just isn’t low enough, that’s when medications come in. For a patient with Secondary Hypertension, the main treatment is to find the disease causing the high blood pressure in the first place and treat accordingly.

For Primary, aka Essential Hypertension, some of the more common medications to give are beta blockers and diuretics, such at metoprolol or Lasix respectively. But you will also see calcium-channel blockers, angiotensin-converting enzyme inhibitors (aka ACE inhibitors), central-alpha 2 antagonists, and alpha-adrenergic antagonists prescribed as well, just to name a few.

If Left Untreated…

If left untreated, hypertension can wreak havoc on the body. Untreated high blood pressure can lead to heart disease, heart failure, heart attack, stroke, kidney disease, hypertensive crisis, and even death. Because of these severe side effects, it is important we educate and continue to re-educate our patients on how to best take care of their body to prevent high blood pressure.

For more information on heart failure, visit Patient Education: What is Heart Failure? Risk Factors, Symptoms, and Treatments.

Do you treat patients with high blood pressure? Comment below!

Plus be sure to check out the entire Patient Education Series:

Referenced CDC hypertension information can be found here.

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Patient Education: What is Hypertension? Causes, Symptoms, and Treatments