Hypertension: Common Chronic Disease Linked to Myocardial Infection - Research Paper

Introduction

Hypertension is a chronic disease that is characterized by blood pressure elevation. Hypertension is closely linked to myocardial infection as it is a risk factor, a hemodynamic factor, and an atherogenic factor. It is a common disorder that affects the large share community as it is mainly asymptomatic (Nadruz, 2015). It is detected after the occurrence of a complication like a stroke or a heart attack. Also, it is identified through regular examination. The paper examines the pathophysiology of hypertension, its pharmacology, and assessment. It also focuses on lab and diagnostic tests of hypertension and nursing care of the disease.

The history of hypertension is a common finding in patients with myocardial infarction, and its frequent association with diabetes, older age, female sex, and more often vascular comorbidities composes a risk profile that is very distinctive from the counterpart, which is normotensive ischemic. In both early and long-term course of acute myocardial infarction, antecedent hypertension is associated with morbid events and higher death rates, especially if the patient is complicated by congestive heart failure or left ventricular dysfunction (Pedrinelli et al., 2012). Hence, hypertension is a risk factor established for adverse cardiovascular outcomes such as stroke, heart failure, and cardiovascular death. The increased incidence of myocardial infarction or death that occurs suddenly in hypertensive patients seems to relate with insulin resistance, endothelial damage, and atherosclerosis.

Pathophysiology of Hypertension

Hypertension is classified by cause into two classifications, which are essential and secondary. Essential hypertension is also known as primary or idiopathic, and many authorities define this type as it is caused by underconsumption of potassium and overconsumption of sodium. The other secondary hypertension is caused by some underlying condition with a mechanism that is well-known, such as narrowing of the aorta, chronic kidney disease, or endocrine disorders, which includes cortisol, aldosterone, and catecholamines (Pedrinelli et al., 2012). The pathogenesis of essential or primary hypertension is highly complex and multifactorial, with kidney acting as both the target and contributing organ of the hypertensive processes.

Hypertension involves the interaction of numerous mechanisms of interdependent or independent pathways with multiple organ systems. Genetic activation plays a vital role in the pathogenesis of hypertension when it comes to systems such as the renin-angiotensin, obesity, sympathetic nervous system, and increased intake of salty dietary. Where it has been identified to be caused by a gene mutation which alters salt handling of the kidney causing high blood pressure, some patients get hypertension through adrenal and renal diseases which raises their blood pressure, as maintaining normal blood pressure involves several physiological mechanisms which cause essential hypertension when they are deranged.

Pharmacology of Hypertension

Pharmacology of hypertension involves the use of many therapeutic agents. For stage one hypertension, the most recommended agent is the initiation of thiazide-type diuretic; this applies to patients at stage one who does not have other indications of other therapies. Also, some of the other drugs that can be used for hypertensive patients are angiotensin-receptor blockers, angiotensin inhibitors that convert enzymes, diuretics, beta-blockers, and calcium channel blockers (Nadruz, 2015). The agents lower blood pressure, but the patient's variability has to be considered because different patients respond differently to a treatment.

Assessment of Hypertension

The assessment of hypertension involves measuring the blood pressure of patients accurately. A focused physical examination and medical history are performed through obtaining laboratory results of the patient (Pedrinelli et al., 2012). Additionally, a 12-lead electrocardiogram is obtained. The assessment steps assist in determining the presence of end-organ disease in the patient.

Hypertension Lab Tests and Diagnosis

Hypertension diagnosis is very significant. Frequent lab tests are essential before the patient begins treatment to determine if there is any tissue or organ damage, or any other risk factors. The tests carried out in the lab are blood cell count, urinalysis, and blood chemistry, which comprises sodium, fasting glucose, potassium, HDL cholesterol, creatinine, and total cholesterol (Nadruz, 2015). For patients with diabetes, a urinary albumin excretion should be assessed in the diagnosis. The blood pressure readings should be examined well to identify the patient is normal, prehypertensive, or hypertensive of different stages, as shown by the interpretations of both systolic and diastolic.

Nursing Care

All hypertensive patients who have been treated should be monitored because they are at risk of developing type 2 diabetes due to cardiometabolic risk factors. The goals of nursing care for hypertension are to control or lower blood pressure in patients, lifestyle modifications, prevention of complications, and adherence to the therapeutic routine. The nurses attending the patient should check the lab data of the patient to enable them to determine the contributing factors so that they can develop a proper care plan. They should also record and monitor changes in blood pressure and observe the color of the patient's skin. Also, note the capillary refill time, auscultate the sound of the patient's breath, advice on sodium intake, and administer medication to the patient.

Conclusion

In conclusion, regardless of the hypertension sovereignty, all the patients suffering from the disease should be offered advice to reduce the level of blood pressure, by telling them to take a keen look on their smoking behavior, do exercise, go for weight reduction practices, take proper diet, and reduce intake of alcohol. Even if treatments of hypertension lessen the risk of cardiovascular and renal diseases, many patients are inadequately treated or are untreated. Poor blood pressure control is caused by failure to provide the correct combination of drugs, optimum drug doses, and lifestyle modifications.

References

Nadruz, W. (2015). Myocardial remodeling in hypertension. Journal of human hypertension, 29(1), 1-6. Retrieved from https://www.nature.com/articles/jhh201436

Pedrinelli, R., Ballo, P., Fiorentini, C., Denti, S., Galderisi, M., Ganau, A., ... & Salvetti, M. (2012). Hypertension and acute myocardial infarction: an overview. Journal of cardiovascular medicine, 13(3), 194-202. https://doi: 10.2459/JCM.0b013e3283511ee2