Example Of Research Paper On Hypertension Education For African- American Males 30-50 Years
Type of paper: Research Paper
Topic: Nursing, Hypertension, Health, Medicine, Therapy, Control, Pressure, Stress
Most African-American men between the ages of 30 to 50 years have a long history hypertension that is often poorly controlled with difficulties in adherence to the treatments which are recommended. Despite serious complications leading to hypertensive emergency that require hospitalization most of these African Americans are usually ignorant and hence a disproportionate number end up becoming affected by hypertension and its consequent complications (Hajjar & Kotchen, 2012). There is still a persistent disparity in the treatment of hypertension between blacks and whites although most dietary and pharmacologic therapies are efficacious. Some of the barriers they face to the effective control of their blood pressure are usually either individual, societal or interactions with health professionals and health system. There is an evidenced based indication that the effective attitudinal, affective and cognitive factors of patients together with the physician- patient relationship play critical roles in the improvement of the outcomes which consequently helps in the reduction of racial disparities in the control of hypertension.
Hypertension often exists in close association with a host of other conditions that have compelling indications requiring the use of specific treatments that are based on studies on clinical data. Such therapies have long standing benefits on the natural history of the particular associated condition. Some of the compelling indications for these specific therapies usually involve risky conditions often direct descendants of hypertension like heart failure (HF), recurrent stroke and chronic kidney disease and or those that are commonly related with hypertension like high coronary disease and diabetes (Bonds, Hogan, Bertoni , 2011). The therapeutic decisions in such individuals should be directed at both the lowering of the blood pressure and of the compelling indication. The absence of positive indicators usually signifies lack of data for particular classes of drugs and therefore for instance, recurrent strokes may require a different treatment strategy as compared to that of the coronary kidney disease (Bonds, Hogan, Bertoni , 2011).
For the management of HF for example, the use of thiazide-type diuretics is often recommended to reduce incidences rates but not to lengthen the survival of affected individuals already having the condition (Hajjar & Kotchen, 2012). There is also the use of therapies that include nursing outcomes classifications (NOC) and nursing interventions classifications (NIC) combination therapies in clinical trials that are now widespread and confound the interpretation of single drug effects. The rate of recurrent stroke is significantly reduced through the use of thiazide-type diuretic which is added to ACEI background therapy. This is according to the Perindopril Protection against Recurrent Stroke Study (PROGRESS) (Hajjar & Kotchen, 2012).
African-Americans of this age bracket are also susceptible to hypertensive emergencies which are characterized by high elevations in their blood pressure BP to (>180/120 mmHg), this is usually complicated by the evidence a progressive or impending target organ dysfunction. Such patients require an immediate reduction of their blood pressure to unnecessarily normal levels to help in the initial prevention of organ damage. Some of these emergencies may include unstable angina pectoris, acute left ventricular failure, hypertensive encephalopathy, acute MI, intracerebral hemorrhage, pulmonary edema, eclampsia or dissecting aortic aneurysm (Bonds, Hogan, Bertoni , 2011). These are often associated severe elevations in the blood pressure without little progression towards target organ dysfunction. Some of these examples include some levels of stage II hypertension that are accompanied by shortness of breath, severe headaches or anxiety and epistaxis. Most of these patients are usually either inadequately treated or noncompliant with little or no evidence indicating target organ damage. It is therefore very critical to establish an early triage for the appropriate therapeutic strategies for such patients to help reduce mortality and morbidity. Patients with severe hypertension often represent almost a quarter of all the visits in busy emergency rooms (ERs) (Bonds, Hogan, Bertoni , 2011).
Through the NOC treatment system, there are broad ranges of how such patients can also get involved and be committed to hypertension therapy. Management strategies should therefore be focused on the specific goals of the patient whilst encouraging adherence and providing advice (Hajjar & Kotchen, 2012). The optimal management strategies however have a high likelihood of differing depending on patient types. Healthy lifestyles should be encouraged to patients as it helps in improving adherence to medication. This is accompanied with the beliefs of such patients to involvement in physical activity, control of alcohol and salt consumption as well as food, beverages and smoking.
A comparison of the two articles indicates a common agreement on the significance of behavioral models which emphasize efficient therapy that is prescribed by very careful clinicians as one of the most reliable control system for the treatment of hypertension. This is especially realized when patients have a motivation to comply with the medication requirements as directed by their physicians to help in the establishment and maintenance a healthy lifestyle. Motivation often improves in instances when the patients trust in their clinicians and have good communication with them which helps to improve the overall recovery outcomes.
The article by Bond et al., 2011, distinctively stresses on the need for health caregivers including nurses, physicians, clinicians and licensed nutritionists and nutrition educators to work together to help reinforce and influence blood pressure control and patient lifestyles and consequently to better hypertension control (Bonds, Hogan, Bertoni , 2011).
Research cited in the other article by Hajjar & Kotchen (2012) on the other hand has an emphasis on the importance of special interest being conferred to the African- American Hypertension of this fragile age bracket because of their high risk and susceptibility to the disease. This group has a high probability of complications which include a 1.9-fold risk of developing the end-stage renal disease together with a 4.6 fold risk of suffering death from related cardiovascular diseases. Although there is a general overall decline in cardiovascular diseases, rates still continue to be high up to 30–50% in African Americans compared to whites (Hajjar & Kotchen, 2012).
Conclusively, there is therefore need for public health nurses as well as community outreach workers within these high-risk communities to increase their efforts of screening, identifying fragile cases, referring and tracking with follow up appointments together with awareness and educational programs to patients to help reduce the overall hypertension incidences.
Bonds, D. E., Hogan, P. E., Bertoni , A. G. (2011). A multifaceted intervention to improve blood pressure control: The guideline adherence for heart health (GLAD) study. PubMed 157:278–284.
Hajjar, I., & Kotchen, T. A. (2012). Trends in prevalence, awareness, treatment, and control of hypertension in the United States. Pub Med: JAMA. 290:199–206.