Question

You meet Mr. Devon Jones who is a 40-year-old African American male with a long-standing history of uncontrolled hypertension. Both of his parents died from hypertension and his mother also had type II diabetes. Mr. Jones is a police officer in a high crime neighborhood. He stopped smoking about 5 years ago when diagnosed with hypertension. He states that he drinks several beers every evening and does not pay much attention to his intake of sodium, fat, or carbohydrates. He does not exercise regularly with the exception of required trainings for his job. His weight has increased by 20 pounds during the past year and he reports some shortness of breath with activity, especially when climbing stairs. choose one pathologic effect of sustained, complicated primary hypertension and give Mr. Jones understanding about its pathophysiology as well as direction for improved self-care to avoid the complication.​

Answer 1

Hypertension is high blood pressure. Blood pressure is the force of blood pushing against the walls of arteries as it flows through them. Arteries are the blood vessels that carry oxygenated blood from the heart to the body's tissues.

Complications of hypertension are clinical outcomes that result from persistent elevation of blood pressure. Hypertension is a risk factor for all clinical manifestations of atherosclerosis since it is a risk factor for atherosclerosis itself.It is an independent predisposing factor for heart failure,coronary artery disease, stroke, renal disease, and peripheral arterial disease.

Mr. Jones has problems like weight gain, shortness of breath with activity especially when climbing stairs which are the indication of having atherosclerosis in the arteries which can lead to coronary artery disease. Hence, Mr. Jone should be educated about the following things:

• Atherosclerosis is a disease in which the inside of an artery narrows due to the build up of plaque. Initially, there are generally no symptoms. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected.
• Risk factors include abnormal cholesterol levels, high blood pressure, diabetes, smoking, obesity, family history, and an unhealthy diet.
• Marked narrowing in the coronary arteries, which are responsible for bringing oxygenated blood to the heart, can produce symptoms such as the chest pain of angina and shortness of breath, sweating, nausea, dizziness or light-headedness, breathlessness or palpitations.
• Medical management of atherosclerosis first involves modification to risk factors–for example, via smoking cessation and diet restrictions. Prevention then is generally by eating a healthy diet, exercising, not smoking, and maintaining a normal weight.
• Diet : Changes in diet may help prevent the development of atherosclerosis. Tentative evidence suggests that a diet containing dairy products has no effect on or decreases the risk of cardiovascular disease. A diet high in fruits and vegetables decreases the risk of cardiovascular disease and death. Evidence suggests that the Mediterranean diet may improve cardiovascular results.There is also evidence that a Mediterranean diet may be better than a low-fat diet in bringing about long-term changes to cardiovascular risk factors (e.g., lower cholesterol level and blood pressure).
• Exercise : A controlled exercise program combats atherosclerosis by improving circulation and functionality of the vessels. Exercise is also used to manage weight in patients who are obese, lower blood pressure, and decrease cholesterol. Often lifestyle modification is combined with medication therapy. For example, statins help to lower cholesterol, antiplatelet medications like aspirin help to prevent clots, and a variety of antihypertensive medications are routinely used to control blood pressure. If the combined efforts of risk factor modification and medication therapy are not sufficient to control symptoms, or fight imminent threats of ischemic events, a physician may resort to interventional or surgical procedures to correct the obstruction.