HYPERTENSION: A NEGLECTING ILLNESS

A Term Paper

Presented to

Mrs. Marilou Cinco-Castro
Butuan Doctors College
J.C. Aquino Avenue., Butuan city


In Partial Fulfilment of the Requirements for
English 2


By

Laiza C. Gonzales

March 2014




HYPERTENSION: A NEGLECTING ILLNESS
Thesis: Hypertension is a common condition among Filipinos and yet is usually
undiagnosed and undetected. Compounded with unhealthy lifestyle and other risk
factors, this causes the untimely deaths of Filipinos even at their productive age.

I. Introduction
A. Definition
B. Incidence of hypertension
II. Body
A. Types of hypertension
1. Primary hypertension
2. Secondary hypertension
B. Changes in blood pressure classification
C. Signs and symptoms
1. Severe headache
2. Fatigue or confusion
3. Vision problems
4. Chest pain
5. Difficulty breathing
6. Irregular heartbeat
D. Causes of hypertension
1. Smoking
2. Being overweight or obese
3. Lack of physical activity
4. Too much salt in the diet
5. Too much alcohol consumption (more than 1 to 2 drinks per day)
6. Stress
7. Older age
8. Genetics
9. Family history of high blood pressure
10. Chronic kidney disease
11. Adrenal and thyroid disorders
E. Treatment
III. Conclusion
A. Implication
B. Limitations















HYPERTENSION: A NEGLECTING ILLNESS

Hypertension, also referred to as high blood pressure, is a condition in which
the arteries have persistently elevated blood pressure. Every time the human heart
beats, it pumps blood to the whole body through the arteries (Neelam, 2009).
The National Nutrition and Health Survey II in 2008 revealed that nine million
Filipinos suffered from hypertension or a prevalence rate of 20 percent, a four-
percent increase since the first National Nutrition and Health Survey was conducted
in 2003, said Dr. Danton Morales, president, Philippine Society of Hypertension in
press briefing organized by Takeda Pharmaceuticals Philippines in Makati City.
It is common but the knowledge is low both males and females. Of the
number of patients with hypertension, only 50 percent were aware, of the treated
ones, 13.1 percent have been treated while only 19.3 percent controlled their high
blood pressure, said Morales.
There are two major types of hypertension and four less frequenting found
types. The two major types are:
1. Primary or essential hypertension, that has no known cause, is diagnosed in
the majority of people.
2. Secondary hypertension is often caused by reversible factors and is
sometimes curable.
Primary (essential) hypertension is the most common form of hypertension,
accounting for 9095% of all cases of hypertension. In almost all contemporary
societies, blood pressure rises with aging and the risk of becoming hypertensive in
later life is considerable. Hypertension results from a complex interaction of genes
and environmental factors. Numerous common genetic variants with small effects
on blood pressure have been identified as well as some rare genetic variants with
large effects on blood pressure but the genetic basis of hypertension is still poorly
understood. Several environmental factors influence blood pressure.
Secondary hypertension results from an identifiable cause. Renal disease is
the most common secondary cause of hypertension. Hypertension can also be
caused by endocrine conditions, as Cushings syndrome, hyperthyroidism,
hypothyroidism, acromegaly, Conns syndrome or hyperaldosteronism,
hyperparathyroidism and pheochromocytoma (Hypertension, 2013).
According to Haller (2013) that the normal level for blood pressure is below
120 over 80, where 120 represents the systolic measurement (peak pressure in the
arteries) and 80 represents the diastolic measurement (minimum pressure in the
arteries). Blood pressure between 120 over 80 and 139 over 89 is called
prehypertension and a blood pressure of 140 over 90 or above is considered
hypertension.

Table 1 Changes in blood pressure classification
Systolic BP/Diastolic BP Category
< 120/80 Normal
120 -139 / 80-89 Prehypertension
140 / 90 Hypertension
140 -159 /90-99 Stage 1
160 / 100 Stage 2

If someone has an extremely high blood pressure, there may be certain
symptoms to look out for including severe headache, fatigue or confusion, vision
problems, chest pain, difficulty in breathing, irregular heartbeat, blood in the urine
and pounding in the chest, neck or ears. Then that person should seek medical
advice immediately. Because he or she could be having a hypertensive crisis that
could lead to heart attack or stroke (Hicks, 2011).
Although the exact cause of hypertension are usually unknown, there are
several factors that have been highly associated with the condition. These include
smoking which injures the blood vessel walls and speeds up the process of
hardening of the arteries. Cigarette contains nicotine; nicotine is a poisonous
alkaloid that is the most chief active principle of tobacco and is used as an
insecticide. Obesity, diabetes, lack of physical activity, high levels of salt intake,
high levels of alcohol consumption, stress, aging, chronic kidney disease, adrenal
and thyroid problems or tumours, and genetics (Hypertension/high blood pressure
Health Center, 2005).
There are effective steps that can lower the blood pressure with the changes
to lifestyle and by taking medication.
Your choice of treatment will depend on your blood pressure level and your
risk of developing a cardiovascular disease, such as a heart attack or stroke.
If your blood pressure is slightly above 130/80mmHg but your risk of
cardiovascular disease is low, you should be able to lower your blood
pressure by making some changes to your lifestyle.
If your blood pressure is moderately high (140/90mmHg or above) and
you're at risk of cardiovascular disease in the next 10 years, treatment
will involve medication and lifestyle adjustments.
If your blood pressure is very high (180/110mmHg or above) you will
need treatment soon, possibly with further tests, depending on your
health.
Below are some changes you could make to your lifestyle to reduce high
blood pressure. Some of these will lower your blood pressure in a matter of weeks,
others may take longer.
Cut your salt intake to less than 6g (0.2oz) a day. Find out how you
can reduce the amount of salt in your diet.
Eat a healthy, low-fat, balanced diet, including plenty of fresh fruit and
vegetables. Get tips on eating more healthily.
Be active: being physically active is one of the most important things
you can do to prevent or control high blood pressure. Get tips
on being more active.
Cut down on alcohol. Get tips on cutting down, download a drinks
diary and keep track of your drinking.
Stop smoking. Smoking greatly increases your chances of getting
heart and lung diseases. Get help quitting.
Lose weight. Find out what your ideal weight is using the BMI healthy
weight calculator.
Drink less coffee, tea or other caffeine-rich drinks such as cola.
Drinking more than four cups of coffee a day may increase your blood
pressure.
Try relaxation therapies, such as yoga, meditation and stress
management.
The more healthy habits you adopt, the greater effect there is likely to be on
lowering your blood pressure. In fact, some people find that, by sticking to a healthy
lifestyle, they do not need to take any medicines at all.
There is a wide range of blood-pressure-lowering medicines to choose from.
You may need to take more than one type of medication because a combination of
drugs is sometimes needed to treat high blood pressure.
In some cases, you may need to take blood pressure-lowering medication for
the rest of your life. However, if your blood pressure levels stay under control for
several years, you might be able to stop your treatment.
Most medications used to treat high blood pressure can produce side effects
but the large choice of blood pressure medicines means that these can often be
resolved by changing treatments (Treating high blood pressure, 2011).
Scientists from the University of California Davis (November 2012) reported
that young and middle aged people with high blood pressure have a higher risk of
accelerated brain aging. The authors say their findings should encourage doctors to
control patients blood pressure early on, even the prehypertensive ones.
Professor Charles De Carli(2012) with his team, said they found evidence of
structural damage in white matter, and also the volume of gray matter among
people with high blood pressure, including prehypertensive patients in their 30s and
40s. They wrote that brain injury develops insidiously over the lifetime with
discernible effect.
High blood pressure makes the heart work harder all the time, as well as the
kidneys. The heart and kidneys work closely together. This eventually causes CHF
(Congestive Heart Failure).
Partly of this occurs from called Left Ventricular Hypertrophy. This means that
because there is so much blood being pumped through your body, and your heart
has to work so much more, the heart muscle becomes thicker. Since the wall of the
pumping chamber of the heart is now thicker, that means that the pumping chamber
itself is now smaller, which means less blood is being pumped out with each beat of
the heart (Riad, 2008).
Health Secretary Enrique T. Ona reminded Filipino adults and young ages to
have their blood pressure measured regularly as the Philippines joins the
celebration of World Health Day last April 7, 2013 to raise awareness and call for
individual actions on addressing high blood pressure with the battle cry, BP: Alamin
at Kontrolin.
World Health Day is celebrated globally on April 7 every year to mark the
anniversary of the founding of World Health Organization (WHO) in 1948. Each
year, a theme is selected to highlight a priority area of public health concern in the
world, and last years focus was on controlling high blood pressure, which is a risk
factor for fatal heart attacks, debilitating strokes, and chronic heart and kidney
disease. Raised blood pressure is known to cause around half of all deaths from
stroke and heart disease.
An overall objective is to develop comprehensive national and local plans
that take advantage of every opportunity to encourage and promote healthy eating
and active living. These plans would involve health care providers, worksites,
schools, media, urban planners, all levels of food production and governments. The
goal is cultural change in the direction of healthy living. An important element in
cultural change is national leadership by individuals and by professional
organizations. Specific interventions will depend on local physical and cultural
conditions and should be based on careful analysis of existing dietary and activity
patterns and their determinants. However, the following interventions can be
considered:
Physical activity
o Develop transportation policies and a physical environment to promote
walking and riding bicycles. This intervention includes constructing
sidewalks and protected bicycle paths and lanes that are attractive,
safe, well-lighted, and functional with regard to destinations.
o Adopt policies that promote livable, walker-friendly communities that
include parks and are centered around access to public transportation.
o Encourage the use of public transportation and discourage
overdependence on private automobiles.
o Promote the use of stairs. Building codes can require the inclusion of
accessible and attractive stairways.
Healthy diets
o Develop comprehensive school programs that integrate nutrition into
core curricula and healthy nutrition into school food services. Regional
or national standards to promote healthy eating should be developed
for school food services. Programs should also aim at limiting
television watching, in part by promoting attractive alternatives.
o Work with the agriculture sector and food industries to replace
unhealthy fats with healthy fats, including adequate amounts of
omega-3 fatty acids. This goal can be achieved through a combination
of education, regulation, and incentives. Specific actions will depend
on local sources of fat and on regional production and distribution. For
example, in areas where palm oil is dominant, research could focus on
developing strains that are lower in saturated fat and higher in
unsaturated fat through selective breeding or genetic alteration.
Labeling requirements or regulation can be used to discourage or
eliminate the use of partially hydrogenated vegetable oils and to
promote the use of nonhydrogenated unsaturated oils instead.
o Require clear labeling of energy content for all packaged foods,
including fast food.
o Use tax policies to encourage the consumption of healthier foods. For
example, high-sugar sodas could be fully taxed and not subsidized in
the same way as healthier foods.
o Emphasize the production and consumption of healthy food products
in agriculture support and extension programs.
o Implement folic acid fortification if folic acid intake is low.
o Ensure that health providers regularly weigh both children and adult
patients, track their weights over time, and provide counselling
regarding diet and activity if they are already overweight or if
unhealthy weight gain is occurring during adulthood. Those activities
should be integrated with programs that address under nutrition.
Health care providers should be encouraged to set a good example by
not smoking, by exercising regularly, and by eating healthy diets.
o Promote healthy foods at worksite food services. Worksites can also
promote physical activity by providing financial incentives for using
public transportation or riding bicycles and by not subsidizing
automobiles by providing free parking. Providing areas for exercise
during work breaks and showers may be useful.
o Set standards that restrict the promotion of foods high in sugar,
refined starch, and saturated and Trans fats to children on television
and elsewhere.
o Set national standards for the amount of sodium in processed foods.
National campaigns
o Invest in developing locally appropriate health messages related to
diet, physical activity, and weight control. This effort is best done in
cooperation with government agencies, nongovernmental
organizations, and professional organizations so that consistent
messages can be used on television and radio, at health care settings,
schools, worksites, and elsewhere. This effort should use the best
social-marketing techniques available, with messages continuously
evaluated for effectiveness.
o Develop a sustainable surveillance system that monitors weight and
height, physical activity, and key dietary variables.
Implementation of the recommended policies to promote health and well-being
is often not straightforward because of opposition by powerful and well-funded
political and economic forces, such as those involved in the tobacco, automobile,
food, and oil industries. The solutions will depend on a country's specific political
landscape. However, experiences in many countries indicate that alliances of public
interest groups, professional organizations, and motivated individuals can overcome
such powerful interests. Strategies should start with sound science and can use a
mix of mass media, lobbying efforts, and lawsuits. Also, the food industry is far from
monolithic, and elements can often be identified whose interests coincide with
health promotion, which can create valuable partnerships. As an example, the
willingness of some margarine manufacturers to invest in developing products free
of trans fatty acids greatly helped the effort to reduce these fats, because these
producers then became proponents for labelling the trans fat content of foods.
Protection of children can be a powerful lever because of almost universal concern
about their welfare and the recognition that they cannot be responsible for the long-
term consequences of their diet and lifestyle choices (Willett, Koplan and Nugent,
2002).














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