Hypertension: Risk Factors, Complications, and Prevention
Risk Factors for Hypertension
Hypertension has several risk factors that fall into two groups namely modifiable as well as unmodifiable risk factors. One of the unmodifiable risk factors is the ethnicity of an individual. An individual’s ethnicity results in inherited differences in the body’s response to salt and hormones. Hypertension is more prevalent among persons of certain ethnic groups such as black persons of Caribbean descent. On the other hand, hypertension is less prevalent among persons of Bangladeshi descent. The other set of unmodifiable risk factors includes the age and gender of an individual (Egan, Zhao & Axon, 2010). The actual relationship between the two factors and hypertension is not well outlined. Men are at a greater risk of developing hypertension as compared to women. An individual’s age also increases the risk levels for being hypertensive.
There are several modifiable risk factors for hypertension that including excessive salt intake. Salt contains sodium as one of the ions which results in water retention in the body and as such the workload of the heart is increased. Being overweight and obese has been shown to increase the risk for hypertension by fourfold. The high risk for hypertension is related to the increase in the fatty tissue that increases the workload of the heart in the process of pumping blood. Persons who engage in less physical activities have an increased risk level of developing hypertension. Excessive alcohol intake also results in an increased risk of hypertension with the most significant increase being noted when individuals engage in binge drinking (Marshall, Wolfe & McKevitt, 2012). Diabetes has also been shown to increase the risk of developing hypertension as it damages the kidneys increasing the amount of water in the body which in turn raises the cardiac workload.
Complications of Hypertension
Prolonged hypertension results in the hardening of blood vessels a condition that is referred to as atherosclerosis. The hardening of blood vessels occurs as a result of the oxidation of low-density lipids that end up being trapped in the matrix of the subendothelial space. Hypertension also increases the pressure on the blood vessels resulting in the bulging of the vessels causing the formation of aneurysms. The increased workload results in the thickening of the heart muscles in an attempt to meet the body’s demands for blood supply (Marshall et al. 2012). The thick heart muscle may result in reduced blood pumping and hence cause heart failure. Hypertension also leads to the thickening of the intima of the eye as well as the degeneration of the sclera. Hypertension results in vascular lesions in the glomerular arterioles of the kidney and as such causes narrowness of kidney blood vessels. Hypertension results in a cluster of disorders of the metabolism that includes increased triglycerides and high-density proteins, as well as elevated insulin levels.
The first consequence of poorly controlled hypertension is related to cerebral vascular accidents leading to a stroke. For patients who develop aneurysms related to hypertension, there is a risk of rupture if hypertension is not controlled. Marshall et al. (2012), argues that uncontrolled hypertension can result in hypertensive crisis with features of high spikes of blood pressure resulting in internal bleeding of the organs such as the lungs and the brain.
Prevention and Management of Hypertension
The prevention of hypertension focuses on modifiable risk factors. There is increasing evidence in the available literature that indicates that lifestyle changes lower the risk of developing hypertension (Egan et al., 2010). The lifestyle changes focus on reducing dietary intake of salt while increasing the consumption of vegetables, as well as fruits. It is important to engage in habitual exercises, as well as lower alcohol intake to prevent hypertension (Sever, Messerli & Messerli, 2011). Establishing mechanisms for early detection among the at-risk group is also significant in the fight to prevent hypertension.
In the management of hypertension, there are conservative approaches as well as clinical management that can be applied. The individuals diagnosed with blood pressure are required to make lifestyle changes that are similar to those applied when preventing hypertension (Egan et al., 2010). Clinical management of hypertension involves the use of various drugs that act on the cardiovascular system. According to Sever et al. (2011), diuretics are the first line in the treatment of hypertension. Other follow-up medications are used to correct side effects that result from the use of diuretics such as the decrease in blood potassium levels.
Statistics on Hypertension
Hypertension contributes significantly to the number of patients that show up at the emergency department. Out of the total number of patients that visit the emergency department, 27.2% have been shown to have moderate hypertension with another 16.3% having severe hypertension. Several studies have shown that the prevalence of non-adherence to hypertensive medication is at 67% among hypertensive patients. According to Egan et al. (2010), the incidence of patients who experience hypotension as a result of misunderstanding the treatment regimen for hypertension is 47.4%. However, the number of patients who misunderstand hypertensive treatment decreases among patients who have been on medication for more than two years.
Egan, G., Zhao, Y., & Axon, R. (2010). US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. Journal of the American Medical Association, 303(20), 2043-2050.
Marshall, J., Wolfe, C., & McKevitt, C. (2012). Lay perspectives on hypertension and drug adherence: systematic review of qualitative research. British Medical Journal, 345, e3953. Web.
Sever, P., Messerli, F., & Messerli, H. (2011). Hypertension management 2011: optimal combination therapy. European Heart Journal, 32(20), 2499–2506.