1. Managing Hypertension Essay
Managing Hypertension EssayManaging Hypertension EssayRunning head: INTRODUCTION
TO THE LITERATURE REVIEW Literature Review Philippa Ehoro Grand Canyon University:
DNP 820 November 04, 2017 1 LITERATURE REVIEW 2 Hypertension is now a global
concern. Its prevalence has greatly increase over the years and continue to be a great
problem for many especially in the minority populations. A study finds that there is a
“significant disparity in the prevalence of hypertension among U.S. black adult and are
known to be the population with the highest prevalence of HBP in the world” (Charles,
Anouk, & Leonard, 2010). Of note, is more prevalent in older adult than younger adults and
disproportionately affects African Americans, with all ages having a higher burden of
hypertension-related complications (e.g., heart failure, stroke, CKD) than individuals of
other races” (Still, Ferdinand, Ogedegbe, and Wright (n.d)). Hypertension is one of the most
treated condition in the clinic setting requiring frequent office or clinic visit in other to
attain an optimal blood pressure goal for most patients. Hypertension, if not well control
can result to preventable disease and if not, death, leading to disability in many such as
stroke myocardial infarction and renal failure which in turn results to ESRD requiring
dialysis when it not detected early or treated amicably. According to Kwon, Choi, Mittman,
Bharmal, Honghu, Vickrey, & … Sarkisian (2015), “it is estimated that someone in the U.S.
has a stroke every 40 sec and dies of one every 4 min”. With this been said, it is very
imperative that all clinical partitional take this into consideration so that early detection
and treatment can commerce by recognizing all patients that have the potential risk of
factors that might predispose them to this preventable disease but at the same time can
cause harm to the human body. One way of doing this, is by proper history taking,
recognizing risk factors such as age, BMI, environment factors, family history and life style
modification. Of note, lack of physical inactivity is a powerful modifiable risk factor for
stroke. Managing Hypertension EssayThis paper is composed of fifteen LITERATURE
REVIEW 3 synthesize empirical scholarly research articles and will be used to conduct a
literature review. Upon reading and reviewing the fifteen article this DNP student was able
to identify five-major concept from the articles review that are related to managing
hypertension in the minority populations are 1. “Most if not all individual with
hypertension, irrespective of race ethnicity will require multiple antihypertensive agents to
reach BP goals” (Ferdinand, et al., 2011). 2. To “evaluate the antihypertensive and safety
result in patients with hypertension and comorbidities of diabetes, cardiometabolic
syndrome, or obesity and in black participants” (Ferdinand, et al., 2012). 3. “improving BP
2. control and reducing recurrent stroke among minority stroke survivors will require
complex strategies” (Spruill, et al) 4. “Evaluation of a training program aimed at providing
culturally appropriate hypertension patient education” 5. Can health “coaching with home
titration of antihypertension medication improve blood pressure control” Introduction of
The Identified Subtheme The identified subthemes are hypertension and it relation to
lifestyle medication and culture in the management of hypertension. This study reports a
behavioral change with in this population of patient once that learnt that life style
modification and implementation of daily medication regiment could control their blood
pressure (Meinema, Haafkens, Jaarsma, van Weert, van Dijk, 2017). The second subtheme
medication regimen and compliance. A study confirmed that frequent clinic visit has helped
patients and provider reach their targeted BP goal LITERATURE REVIEW 4 to improve
outcome. Patient were also advised to monitor their blood pressure at home on a regular
basis to help the patient be more conscious of her environment for risk factors that could
potentially increase her blood pressure. Managing Hypertension EssayORDER NOW FOR
CUSTOMIZED, PLAGIARISM-FREE PAPERSTarget organ damage prevention and disable-
this are potential complications from uncontrolled blood pressure. Summary of The
Research Questions Posed by The Studies One of the question was aimed at finding out
whether knowledge of MI alone is sufficient to deliver quality to minority patient.” Due to
the lack of health care in this population of patient, most times hospitals or health care
facilities denies treatment for these patients. for this reason, many have now positively
influence by their environment and tried to adhere to their treatment recommendation
(Meinema et al., 2017). In the minority group with hypertension, how does medication
regimen compared with lifestyle modification reduce the cardiovascular event within the
first year of diagnoses. Has stated by Viera, Kshirsagar, and Hinderliter (2007), our lifestyle
habit and numerous environmental factor such as insufficient fruit intake, vegetables
obesity, physical inactivity couple with large amounts of saturated fat, high salt diet, and
excessive alcohol intake can contribute to high blood pressure. Modifying these lifestyle
factors has proven effective in lowering bp levels.” Summary of The Sample Populations
Used Notice that most of the article have a enough sample size and the population of
patients are ranging between >18 years and older. The articles are more targeted to the
treatment of and management of hypertension in this age group and how the environment
can negatively affect the younger adult. As stated by Cooper et al., many researches have
documented the relationship between socioeconomic status and health: the lower the
socioeconomic status, the higher the risk LITERATURE REVIEW 5 of morbidity and
mortality.” Most of the studies have the inclusion and the exclusion form of sample
collection.Managing Hypertension EssayMost patient their blood pressure had to be high for
one to be eligible. “patients were eligible if they had blood pressure of at least systolic or at
least 90 diastolic mm Hg” (Margolius, Bodenheimer, Bennett, Wong, Ngo, Padilla, & Thom,
2012) Summary of The Limitations of The Studies With article one, there are several
limitations to the study. The article is limited because of the forced-titration design used
and was conduction in a short period of about 8 weeks limiting them from evaluating the
morbidity and mortality outcome. The author also reported that a control group was not
utilized for the triple combination therapy group or internal control groups for the dual
3. combination therapy group” there by limiting the study conclusions regarding efficacy
(Ferdinand, et al., 2011). The second article was limited because of the small sample size
and of note, the “subgroup result stem from the ascent study design” and the lack of
cardiovascular outcomes assessment (Ferdinand, et al., 2012). The third article limitation
are failure to follow up among physicians, which affect their sample size. Second limitation
also, includes failure to reach the “recruitment target among patients” which affected the
statistical studies power to help differentiates the primary outcome (Cooper et al., 2009)
Summary of The Conclusion and Recommendations for Further Research The summary of
the article result show that dual or combination of aliskiren/amlodipine is well tolerated
and very effective in lowering BP in the high-risk patient populations of black race and also
the addition of HCTZ can also provide additional benefit while maintaining tolerability.
There are no recommendations for further research in most of the articles. Rather they
emphasize more on the important of multiple medication regimen in those patient with
stage LITERATURE REVIEW 6 2 hypertension, the benefit of patient centered care and how
it can improve patient adherence and promote health outcome (Copper, et al., 2009). In
conclusion, high blood pressure has aids in the promotion of unwanted disease that could
have been prevented. Managing Hypertension EssayHowever, with proper intervention and
early detection, providers are able to stop the progression of disease they’re by preventing
disability in so many patients. cost care also be reduced if patient and provider are able to
recognize this disease on time by proper educating each patient especially those with
increased risk factors. According to Still, Ferdinand, Ogedegbe and Wright, nonfatal stroke
are 1.3 times more common in the African Americans are, likely to have fetal stroke about
1.8 times, likely to die from heart disease 1.5 times, and would develop end-stage renal
disease as whites 4.2 times. LITERATURE REVIEW 7 Reference Charles, E., Anouk L., G., &
Leonard E., E. (2010). The Effect of Minority Status and Rural Residence on Actions to
Control High Blood Pressure in the U.S. Public Health Reports (1974-), (6), 801. Ferdinand,
K. C., Weitzman, R., Purkayastha, D., Sridharan, K., & Jaimes, E. A. (2012). Research
Article:Aliskiren-based dual- and triple-combination therapies in high-risk US minority
patients with Stage 2 hypertension. Journal Of The American Society Of Hypertension, 6219-
227. doi:10.1016/j.jash.2011.12.002 Ferdinand, K. C., Weitzman, R., Israel, M., Lee, J.,
Purkayastha, D., & Jaimes, E. A. (2011). Research Article: Efficacy and safety of aliskiren-
based dual and triple combination therapies in US minority patients with stage 2
hypertension. Journal Of The American Society Of Hypertension, 5102-113.
doi:10.1016/j.jash.2011.01.006 Kwon, I., Choi, S., Mittman, B., Bharmal, N., Honghu, L.,
Vickrey, B., & … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: a randomized
controlled trial of a stroke risk reduction walking intervention among racial/ethnic
minority older adults with hypertension in community senior centers. BMC Neurology,
15(1), 91-101. doi:10.1186/s12883-015-0346-9 Roter, D., , , Cooper, L. A., Miller, E. I.,
Levine, D. M., & … Barr, M. S. (n.d). A randomized controlled trial of interventions to enhance
patient-physician partnership, patient adherence and high blood pressure control among
ethnic minorities and poor persons: study protocol NCT00123045. Managing Hypertension
EssayImplementation Science, 4 Spruill, T. M., Williams, O., Teresi, J. A., Lehrer, S., Pezzin, L.,
Waddy, S. P., & … Valsamis, H. (2015). Comparative effectiveness of home blood pressure
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Literature Review …………………………………………………………………………………..1 Theoretical
Foundations…………………………………………………………………………………….5 Review of the
Literature ……………………………………………………………………………………7 Theme 1. You may
want to organize this section by themes and subthemes. To do so, use the pattern below.
……………………………………………………………………..10 Theme 2. Chapter 2 can be particularly
challenging with regard to APA format for citations and quotations. Refer to your APA
manual frequently to make vi sure your citations are formatted properly. It is critical that
each in-text citation is appropriately listed in the References section.
………………………………………………….12 Summary
……………………………………………………………………………………………………….15 Chapter 3:
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……………………………………………………………… Error! Managing Hypertension EssayBookmark
not defined. 1 Chapter 2: Literature Review Hypertension is a global concern and its
prevalence has greatly increase over the years and continue to be a great burden for many,
especially in the minority populations with emphases geared towards the African American
decent. African American patients have the greatest burden when it comes to hypertension.
Study have shown that hypertension prevalence is highest in the minority patient’s
population most especially among U.S. black adult (Charles, Anouk, & Leonard, 2010). Other
study reports that High blood pressure (BP) affects African American community more than
people from other ethnic group in the U.S., and its persistent disparity has been linked to
socioeconomic shortcoming (Anderson & Armstead, 1995; Go et al., 2014; Coulon, & Wilson,
2015). Of note, it tends to be prevalent in older adult than younger adults and
disproportionately affects African Americans of all ages with a higher burden of
hypertension-related complications (i.e., heart failure, stroke, Chronic kidney disease) than
6. individuals of other races (Still, Ferdinand, Ogedegbe, and Wright (n.d)). Hypertension is
one of the most treated condition in the clinic setting requiring frequent office or clinic visit
in other to attain an optimal blood pressure goal for most patients. Hypertension can be a
very debilitating disease that can result to so many health complications; it is the leading
cause of cardiovascular event worldwide, the leading global risk for mortality worldwide
and of note, it ranks first (Gu, Li, Yang, Wang, Bo, & Liu, 2015). Thus, this can be prevented
by taking prescribed medication regimen as directed by their provider, early detection
through proper history taking and self-awareness, 2 proper education on self-management
and life style modification, managing daily stress, and partaking in regular physical activity,
all this are necessary to improve the quality of life for those with high blood pressure
(Wright, Still, Jones, & Moss, 2018). The challenge is to assess the knowledge level of the AA
patients in understanding their disease process and its financial burden in relation to cost.
It is estimated that the direct annual cost by 2030 will be 200.3 billion reflecting an increase
of 130. Managing Hypertension Essay
