Paper Example on Hypertension

The Pathophysiology of The Disease

Hypertension, also known as high blood pressure, is a vascular regulation disease that is brought about as a result of the pressure control mechanisms of the artery. Basically, when there are an increased peripheral vascular resistance and cardiac output, there is an elevation of blood pressure. Hypertension can be classified into two. These include primary or essential hypertension and secondary hypertension. Primary hypertension is characterized by a high diastolic and systolic pressure of 90mm Hg and 140 mm Hg respectively. On its part, secondary hypertension primarily results from endocrine disorders, renal disease, and coarctation of the aorta. Any of these conditions could lead to accelerated hypertension, which is a medical emergency characterized by rapid elevation of the blood pressure. This puts the target organs of the kidney, heart, and brain at risk (McCance & Huether, Pathophysiology: the biologic basis for disease in adults and children, 2015).

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Although hypertension is treatable, most patients are not aware and remain untreated or ineffectively treated. Some of the risk factors of the disease include overweight, diabetes mellitus, age (between 30 and 70), sleep apnea, cigarette smoking, skin color (black), sedentary lifestyle, and family history. Usually, the disease does not present any over symptom, and that is why it is referred to as the "silent killer" disease. Untreated hypertension may progress to the coronary artery, stroke, retinopathy, heart failure, and coronary artery disease (McCance & Felver, 2018).

The Common Clinical Manifestations of Hypertension

Hypertension does not usually manifest itself on its victims. Until they are measured, people with the disease are not aware that they have high blood pressure. However, when they are exposed to increased levels of blood pressure, they might develop complications. Hypertension can be manifested in the brain and heart. Brain symptoms can include dizziness, nausea and vomiting, headache, and blurred vision while heart manifestations include shortness of breath, chest pain, and weakness. When it becomes chronic, it can lead to heart failure, heart attack, stroke, eye damage characterized by progressive loss of vision, aorta outpouchings, kidney failure, and peripheral arterial disease (Barker, 2003).

Differential Diagnoses for Hypertension

A sphygmomanometer (blood pressure cuff) is used to measure blood pressure. An automatic machine, a gauge and a cuff or a stethoscope help in this process. Other forms of measurements include checking the patient's respiratory rate, weight, pulse rate, and temperature. The healthcare practitioner can also probe the patient on issues pertaining to his or her family background, medical history, and use of any medication including over-the-counter medications, food additives, prescriptions, and herbal remedies. Also, questions may touch on lifestyle habits such as alcohol consumptions, illegal use of drugs, and smoking (Beevers, Lip, & O'Brien, 2010).

Diagnosis can also involve a physical examination of the patient. This includes listening to and feeling the abdomen to find out if the aorta is enlarged, feeling for ankles and wrist pulse, and listening to the lungs and heart. Moreover, the practitioner can as well listen in the neck to establish the presence of carotid bruits and in the abdomen for an abdominal aortic aneurysm-made bruits. Using an ophthalmoscope to examine the eye can assist in finding the minute blood vessels found on the retina found at the back of the eyeball. Such hypertension risks as stroke and heart disease can be assessed by blood tests. On the other hand, measurement of kidney function is done using electrolytes, creatinine, complete blood count, glomerular filtration rate, and blood urea nitrogen (BUN). The levels of triglyceride and cholesterol in blood will be measured by fasting lipid profile (Aiyagari & Gorelick, 2016).

The Lab Tests That Would Confirm the Hypertension Diagnosis and Expected Results

Electrocardiogram

This can help to evaluate the rhythm and rate of the heart. It is a screening test that assists in assessing the thickness of the heart muscle. If there is long-standing hypertension, the heart muscle will become larger or hypertrophy to push blood within the body's arteries against increased pressure (Aiyagari & Gorelick, 2016).

Echocardiogram

This involves examining the heart via an ultrasound to evaluate its anatomy and function. The test is interpreted by a cardiologist who then evaluates the muscle of the heart to establish its thickness, how efficient it can pump blood to the rest of the body, and whether its movements are appropriate. It can also assess the valves of the heart to establish if there are any leaking or narrowing. Moreover, using a chest X-ray, the size of the heart, lungs, and shape of the aorta can be screened (Aiyagari & Gorelick, 2016).

Doppler Ultrasound

This laboratory test is used to check the flow of blood through the arteries in the arms, feet, and legs at the pulse point. It accurately tests the hypertension associated peripheral vascular disease.

Abdominal Ultrasound

This is used to evaluate abdomen located organs and the flow of blood in the main arteries such as the aorta, the kidneys, the renal arteries, the intestine, and the mesenteric arteries (Aiyagari & Gorelick, 2016).

Analysis of The Current Protocol for Treatment of Hypertension

The best treatment for high blood pressure is lifestyle adjustments. This involves regular exercise and stress reduction. A 30 minutes moderate intensity exercise daily such as jogging, swimming, walking, and cycling is appropriate for a hypertension patient. Blood pressure can also be controlled by managing stress and avoiding smoking, unhealthy eating, alcohol, and drugs. However, those whose hypertension exceeds 130 over 80 can use medication for treatment. Drugs should be started at low doses. Antihypertensive drugs do not have serious side effects on users. Some of the types of drugs used include central agonists, vasodilators, calcium-channel blockers, and angiotensin receptor blockers (McCance & Felver, 2018).

References

Aiyagari, V., & Gorelick, P. B. (2016). Hypertension and Stroke: Pathophysiology and Management. Cham: Springer International Publishing: Imprint: Humana Press.

Barker, D. J. (2003). EDITORIAL: The developmental origins of adult disease. European Journal of Epidemiology, 18(8), 733-736.

Beevers, G., Lip, G. Y., & O'Brien, E. (2010). ABC of Hypertension. Hoboken: Blackwell Publishing Ltd.

McCance, K. L., & Felver, L. (2018). Study guide for Pathophysiology: the biologic basis for disease in adults and children, eighth edition. St. Louis, Missouri: Elsevier.

McCance, K. L., & Huether, S. E. (2015). Pathophysiology: the biologic basis for disease in adults and children. St. Louis: Mosby.