Question

2. The community health nurse is preparing a program about hypertension for a local community center. The focus of the program is on the reduction of risk factors and compliance for those who have been diagnosed with high blood pressure. The target population includes older adults (Learning Objectives I to 4) SHIF соммиа LOL

Answer 1

2. Community Health Program about Hypertension

a. The following are the risk factors of primary hypertension in the older population

• Age: The risk of hypertension is increased with age. Generally, adults with age of 64 years and above are more prone to get hypertension easily.
• Gender: when compared with men women are more prone to get hypertension when age increases.
• Obesity: Being overweight tend to increase the need for blood supply to meet the oxygen and nutrients requirement. the volume of blood increases the pressure inside the vessels also increases.
• sedentary lifestyle: Lack of physical activity leads to overweight and thereby increases the workload of heart muscles which results in primary hypertension.
• Use of tobacco, smoking, and alcohol: Too much of smoking, chewing tobacco, drinking alcohol affects the artery walls and thereby increases the blood pressure.
• Too much of sodium in the diet: Too much intake of salt results in retention of sodium in the body which again increases the blood pressure.
• Sleep: Lack of sleep, increased level of stress all increases the risk of blood pressure in older adults.

b. According to the seventh report of the Joint National Committee, hypertension can be classified as

	Systolic Blood pressure (mm of Hg)	Diastolic blood pressure (mm of Hg)
Normal	120	80
Prehypertension	120 - 139	80-89
Stage 1 hypertension	140-159	90-99
Stage 2 Hypertension	>160	>100

c. As age increases, the walls of arteries and arterioles of the blood vessels become thicker and expands. This results in a reduction of elasticity of the blood vessel. Thus the alterations in the structure of arteries make increases in systolic blood pressure because of the widening of pressure propagation. The increase in capillary resistance results in increased diastolic pressure. As age increases, the change of function of the nervous system, hormonal changes, altered metabolism all together results in high blood pressure.

d. Lifestyle Modification to decrease the risk of hypertension:

• Eat a healthy diet with low sodium.
• Regular exercise to decrease the structural and functional changes of arteries with age.
• Maintain a healthy weight and avoid overweight which increases the risk of blood pressure and heart disease.
• Avoid the intake of alcohol and quit smoking.
• Older adults with hypertension should continue with drug therapy and control blood pressure to prevent further complication.