Managing Hypertension

Registered nurse Sandra A. Moulton is an urgent care coordinator at Toronto Central Community Care Access Centre in Toronto, Canada and has been a part-time clinical instructor at the University of New Brunswick Nursing School of Health Sciences. She lives in Scarborough, Ontario Canada. Elaine A. Moore has worked in hospital laboratories for more than 30 years, primarily in immunohematology and toxicology. She is a freelance medical writer and laboratory consultant. For more information, visit her website at www.elaine-moore.com. She lives in Sedalia, Colorado.

• Table of ContentsAcknowledgmentsPrefaceIntroductionPart1. Hypertension: An OverviewOverview of Blood Pressure and High Blood Pressure 8Are There Symptoms of High Blood Pressure? 8Blood Pressure Measurements 9Proper Steps to Measure Blood Pressure Manually 9What Is Hypertension or High Blood Pressure? 11Prehypertension 13Risk Factors for Prehypertension 15Prehypertension Stages 15I’ve Been Diagnosed with Prehypertension. What Is the Course of Action? 15Dentistry and Hypertension 18Home Blood Pressure Monitoring 19Classifications of High Blood Pressure 19Etiology (Causes) of Hypertension 20Adult Blood Pressure Levels 20Risk Factors for Hypertension 222. Hypertension PrevalencePrevalence of Hypertension in African Americans 23Diseases Attributable to Hypertension 24Statistics of Hypertension, Mortality, and Morbidity—A Brief Overview 27Manifestation of Hypertension (Pathophysiology) 29Sodium Sensitivity 29Genetics 30Natural History of Essential Hypertension 31How Complicated Hypertension Affects Target Organs 31Variation in Rates of High Blood Pressure by Age, Gender, and Race 33Brief Overview: Role of the Heart in Blood Pressure 34Position of the Heart 353. Cardiovascular DiseaseHome Blood Pressure Monitoring 38Negative Outcomes of Clinic Visits Versus Home Blood Pressure Monitoring 39Self-Management for Hypertension Using Home Blood Pressure Monitoring 40Ambulatory Blood Pressure Monitoring 44Reducing Risk Factors of Coronary Heart Disease in Special Populations to Meet Healthy People 2020 Objective 47Hypertension and Its Relation to Left Ventricular Hypertrophy 49Prevalence of Cardiovascular Disease (CVD) 51Definition of Heart Failure 53Stages of Heart Failure 54Heart Failure in Ethnic Minority Populations in Canada 55Role of Diabetes and Coronary Artery Disease 56Hypertension and Heart Disease in Diabetes 57Some Coronary Artery Changes in People with Diabetes and Whether Vitamin D Deficiency Plays a Role 58Biochemical Changes in Diabetes 61Diabetic Atherosclerosis 61Diabetic Coronary Plaque 61Heart Disease Risk Factors 624. Vitamin DWhat Is Vitamin D and How Is It Metabolized? 64Functions of Vitamin D 65Does Vitamin D Play a Role in the Development of Hypertension? 66Some Food Sources of Vitamin D 68The Connection Between Vitamin D Insufficiency and Blood Pressure: A Comparison 68Lower Vitamin D Levels and Mortality 69Parathyroid Hormone and Vitamin D Levels 71Low Vitamin D Levels and Cardiovascular Disease 725. Kidney DiseaseBrief Description of the Kidneys 73Functions of the Kidneys 73Causes of Kidney Disease 74The Kidneys: Fluid Balance, Electrolytes, and Waste Products 75Renin and Blood Pressure 76Economic Impact of Kidney Disease in the United States 76Two Major Complications of Chronic Kidney Disease (CKD) 77Chronic Kidney Disease and Its Prevalence 77Prevalence of ­End-Stage Renal Disease 79Kidney Disease and Hypertension 79Does Weight Play a Role in the Development of Chronic Kidney Disease? 80Left Ventricular Hypertrophy and Hypertensive Chronic Kidney Disease 83Diabetic Kidney Disease and Blood Pressure 84Definition of Chronic Kidney Disease 84The Five Stages of Chronic Kidney Disease and Their Detection 85Modalities for Kidney Failure—Brief Statistics 86Hypertension and Kidney Disease 86Uncontrolled Blood Pressure and Chronic Kidney Disease 87Autoimmune Diseases and Chronic Kidney Disease 87End-Stage Renal Disease Treatment in the United States 88Peritoneal Dialysis and Hemodialysis 89Vascular Access: A Brief History of the Pioneers 90Three Types of Vascular Access 90Arteriovenous Fistula 90Advantages of Arteriovenous Fistula 92Disadvantages 92Maintenance of Arteriovenous Fistula 92Live Kidney Donors and African Americans 946. Stroke and Cerebrovascular DiseaseStroke Mortality Reduction in the United States 97Risk Factors for Stroke 97Possible Cause of Stroke 98How Does Stroke Happen? 98Prevalence of Stroke 99Avoidable Deaths Statistics from Stroke, Hypertension, and Heart Disease in the United States 99Strategies to Avoid Stroke Deaths 100Mortality: Stroke 101Lifestyle Changes for Decreasing Stroke Risk 101Stroke Types 103Economic Impact of Stroke 105High Blood Pressure and Ischemic Stroke 105Genetic Variation and Intracerebral Hemorrhage 107Disparities in Stroke Risks 107Effects After Stroke 112Part7. Nonpharmacological Management for HypertensionIndividual Lifestyle Modifications for Hypertension Management 117The Roundtable Recommendation for Blood Pressure Management: The Lifestyle Approach 119An Overview of the GenSalt Study 121Adherence Interventions: Lifestyle Modifications, Medicine and Home Blood Pressure Monitoring 122Intervention Approach: Blood Pressure Improvement in Primary Care for African AmericansUtilization of Community Settings for Lifestyle Interventions 124Church Interventions to Promote Lifestyle Changes 127Dietary Supplements for Hypertension 128Physical Activity for Hypertension Management 129Hypertension: Gait Slowing in Older Adults 132Nutritional Intake and Physical Activity as Cardiovascular Risk Factors 135Self-Efficacy and ­Self-Care Management for Hypertension 138A Review of ­Patient-Tailored ­Self-Management for Blood Pressure 139Definition of ­Self-Management 140Self-Management for Blood Pressure Control 140Tailored Interventions’ Effectiveness: ­Self-Management Behaviors for Chronic Diseases 1428. Pharmacological Management for HypertensionHypertension and Increased Age 147Consistent Care Versus Standard Care for Blood Pressure Control Among African Americans and Whites 148Medicine 148Forms of Medication Used for Hypertension 149Functions of Blood Pressure Medications 149Some Popular Blood Pressure Medications 149JNC 8 Guidelines 153Resistant Hypertension 154A Glance: Hypertension Management by Various Hypertension Societies 159Differences in Medication Response in ­Non-Hispanic Whites and African Americans 161Medication Adherence 161Factors or Barriers to Medication Adherence for Hypertension in Different Cultural Groups 163Factors That Affect Medication Adherence in African Americans with Hypertension 1679. Hypertension Case StoriesThe Story of an African American Woman 171The Case of Jasper (J.M.) 172Janice: A New Diagnosis of Hypertension and Kidney Failure 173Donald’s Story 17410. Hypertension: Prevalence, Consequences and Lifestyle Modification FactorsHypertension Prevalence in Football Players 177Prehypertension and Hypertension: Physical Therapists’ Involvement 178High Blood Pressure in Blacks 180Question: ­Self-Report Questionnaires for Antihypertensive Medication Adherence 182Cardiovascular Disease 183Cardiovascular Disease Risk Factors: Differences in Various Ethnicities in Canada 187Women and Coronary Artery Disease 190Blood Pressure and Cardiovascular Disease 191Chronic Kidney Disease (CKD) 193End-Stage Renal Disease: Psychosocial Impact and Knowledge NeedsOverview of Vitamin D, Hypertension and Cardiovascular Disease Summary 203Appendix 1. Sample ­Five-Day Meal PlanAppendix 2. Test Your Knowledge of HypertensionBibliographyIndex