The Health Implications And Clinical Significance Of The Management Of Hypertension

Funom MakamaStarred Page By Funom Makama, 20th Mar 2014 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

Hypertension requires treatment and supervision by a medical doctor. Things to put into major considerations are: the goal of treatment, clinical evaluation, minimum routine investigations and cardiovascular risks.

Clinical Considerations

Goal of treatment: The primary goal in treating hypertension is to normalize the blood pressure, not just to reduce it and to prevent complications such as damage to the heart, brain or kidneys. This requires treatment of all the reversible risk factors identified as well as treatment of the raised blood pressure per se.

Clinical evaluation: Make sure the following are carried out: confirm a chronic elevation of BP and determine the level; exclude or identify secondary causes of hypertension, determine the extent of target organ damage and qualify its extent, search for other cardiovascular risk factors and clinical conditions that may influence prognosis and treatment.

Minimum Routine investigations: These include: clinical and family history, full physical examination and laboratory investigations (such as urinalysis for protein, glucose and blood, microscopic examination of urine, fasting blood sugar, blood electrolytes and creatinine, total cholesterol, HDL and LDL and finally ECG).

Level of cardiovascular risk: Decisions about the management of patients with hypertension should not be based on the level of blood pressure along but also on the presence of other risk factors, concomitant diseases such as diabetes, target organ damage and cardiovascular or renal diseases as well as other aspects of patient’s personal, medical and social situations.

This is useful for determining the threshold for initiating antihypertensive drug treatment, and in setting the goal blood pressure that should be achieved and the intensity with which this goal should be pursued.

Management Strategy

• Institute immediate drug treatment for hypertensives in high risks group
• Monitor blood pressure for some weeks before deciding whether to institute drug treatment for those in medium risk group
• Observe the patient over a significant period of time before deciding whether to institute drug treatment for those in low risk groups.

The overall management may be in two parts:
Lifestyle modification (or non-pharmacological treatment): Usually, lifestyle modification helps a lot. This should be instituted wherever appropriate in all patients including those who require drug treatment. They are used for a number of complementary reasons as outlined in WHO Technical report- Hypertension Controls.

• To lower the BP in individual patient
• To reduce the need for antihypertensive drugs and maximize their efficiency
• To address other risks present
• For primary prevention of hypertension and associated cardiovascular disorders in the populations.

Effective implementation of these non-pharmacological measures requires enthusiasm, knowledge, patience and time spent with patients and their families. It is best undertaken by well trained health professional and should be backed up by simple clear written information. Lifestyle measures include: stop smoking, reduce weight (if overweight) and maintain ideal weight, restriction of salt intake, exercise on regular basis, minimize alcohol consumption, reduce stress and think positively, learn to check your BP at home and dietary changes.

A healthy eating plan can both reduce the risk of developing hypertension and lower an already elevated blood pressure. For an overall eating plan, consider the DASH diet, “DASH” stands for “dietary approach to stop Hypertension”, a clinical study that tested the effects of nutrients on blood pressure. Study results indicated that blood pressures were reduced by an eating plan that emphasizes fruits, vegetables and low fat dairy foods and is low in saturated fat, total fat and cholesterol. The DASH diet includes whole grains, poultry, fish and nuts and has reduced amount of fats, red meats, sweets and sugared beverages.

So, by eating fewer processed or refined foods, more fruits and vegetables (which contain potassium) and low-fat dairy foods (which contain calcium and magnesium), you can increase your intake of helpful nutrients and decrease your salt intake at the same time. The safest way to ensure good nutrition is through a balanced, varied diet instead of through nutritional supplements.

Drug Treatment (Pharmacological Therapy)

Medicines used to control hypertension are called antihypertensive. If lifestyle changes do not lead to the desired antihypertensive effect, medical treatment for hypertension may become necessary. It is important that you take your blood pressure medication exactly as your doctor has prescribed it.

For more interesting and very important health related and medical articles, click on the links below
1. General Considerations, Clinical And Medical Classifications Of Anemia
2. Heart Failure: Definition, Detailed Causes And Precipitating Factors Of Cardiac Failure
3. Special Investigations In Cardiology II: The Significance Of Echocardiography
4. Clinical Significance And Health Importance On The Actions Of Adrenocorticotropic Hormone (ACTH) On The Adrenal Cortex

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Comments

author avatar Fern Mc Costigan
21st Mar 2014 (#)

Interesting post!

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author avatar Funom Makama
21st Mar 2014 (#)

Thanks a lot Fern Mc!

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author avatar Funom Makama
22nd Mar 2014 (#)

These scammers will not seize to amaze me... I will leave this message here for everyone to see and know who you are!

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