HYPERTENSION
Health issue
Hypertension is a common health issue among the different populations in the united stated. 45% of the adults have hypertension with only 24% having their condition under control (Hajjar & Kotchen, 2015). According to the CDC 2019, hypertension is prevalent and more destructive among African Americans than any other racial group. African Americans are twice likely to have 4-5 cardiovascular risk factors, hence, there is a need to put greater attention to the management of blood pressure (CDC, 2019). A lot of speculations have been placed on different etiology and pathophysiology, but there are no unique causes that can explain the high prevalence in African Americans. The prevalence of obesity (51%), and salt sensitivity have been proposed to explain the rapid rise in hypertension in AA (Hekler et al., 2019). What poses a great concern among this group and a barrier to blood pressure control is adherence and compliance issues. To achieve excellent blood pressure control, an approach that integrates cultural, physiological, socioeconomic, and epidemiological differences should be utilized. I
Opposition or advocacy of the Issue
Hypertension is among the leading causes of mortality and morbidity in the U.S., and a common risk factor to cardiovascular disorders (CDC, 2019). This issue does not face any opposition as it is a major concern, and the government, healthcare system, and the patients should be actively involved in reducing the prevalence. Apart from cultural concerns among the patients, hypertension calls for attention in all sectors of health and politics. Effort should be placed in modifying the lifestyles of the population and enhancing drug adherence. The proposed lifestyle modification includes weight reduction, smoking cessation, limiting alcohol consumption, and increasing physical activity (Hajjar & Kotchen, 2015). These cases can be reduced through cost-effective and safe measures. The predisposing factors are easily modifiable which makes prevention of hypertension necessary. The policymakers should address the existing health disparities, and offer opportunities for health providers to intervene and impact on the vulnerable populations.
From the perspectives of medical practitioners and patients, it is seen that the patient undergoes several challenges either due to a lack of awareness or cultural beliefs. Dr. Hasbrouck, a medical attendant stated that although the symptoms are silent killers, uncontrolled blood pressure causes devastating effects to the body. Patients are given medication, which when they feel better, they stop taking them, thus it is important to improve health education. “This ongoing tension in the circulatory system can result in heart disease, stroke, blindness, chronic kidney disease and ultimately results in premature death for far too many.” (Nesbitt, 2019). In pursuing lifestyle changes, politicians need to step up and be actively involved through promoting community initiatives and allocating resources to the vulnerable populations.
Position statement analysis
Hypertension is responsible for approximately 700 000 to one million deaths each year. The cost of high blood pressure management averages $131 billion each year, and the hypertensive individuals utilize an annual expenditure of $2000 yearly compared to other patients (Hajjar & Kotchen, 2015). The Global Standardized Hypertension Treatment project was established to utilize immediate simple and achievable methods to lower blood pressure especially among the vulnerable populations (Hekler et al., 2018). The funds and resources allocated in fighting against the rising hypertension cases could have been used to provide other social amenities such as the construction of hospitals in a local setting, hiring more health providers, and availing comprehensive services. Nesbitt (2019) stated that apart from poor health status among these populations, they have high illiteracy levels, poor employment, housing, and poor nutrition. This is were the political leaders come in. Every election year they obtain votes from the vulnerable populations after making a lot of promise. But in the end, what happens? the state remains unchanged awaiting the next leader to grab the opportunity and get richer.
The rising instances of cardiovascular disorders are responsible for morbidity and mortality cases. For example, in the Covid-19 pandemic, the most affected are those with underlying health conditions, children, and the elderly. The leading mortality cases are due to heart diseases: hypertension, and diabetes. The impact it has on the economy is tremendous calling for all responsible stakeholders to be actively involved in lowering the cases of chronic diseases and casualties (Hekler et al., 2018). Many patients do not understand the need for long-term drug therapy, which increases the need for education and creating awareness. Based on reports by health providers, individuals accompanied by their family during routine appointments display improved adherence and reduction in blood pressure compared to unaccompanied ones. The use of exercises and a strictly reduced salt diet is more effective in lowering BP compared to the use of drug therapy (Nesbitt, 2019). Therefore, in concurring with the opinion that a combination of drug adherence, lifestyle modifications, and health education while enhancing self-management will improve the outcomes of health, and reduce the cost of management.
Conclusion
Looking at a different perspective from health providers as well as researchers, it is evident that hypertension is an important health issue. It is among the leading causes of mortality in the U.S. There is a need to integrate management initiatives that improve health outcomes and reduce the cost. The efforts of the patient, family, health providers, and the government are needed to reach the set goals, improve living standards, and the quality of life. Given an opportunity to work in a rural health facility, what approach would you utilize to reduce hypertensive cases? As a policy advocate, how would you help this population in selecting their leaders?
References
Centers for Disease Control and Prevention (2019). Hypertension Cascade: Hypertension Prevalence, Treatment and Control Estimates Among US Adults Aged 18 Years and Older Applying the Criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2013–2016external icon. Atlanta, GA: US Department of Health and Human Services.
Hajjar, I., & Kotchen, T. A. (2015). Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. Jama, 290(2), 199-206. doi:10.1001/jama.290.2.199
Hekler, E. B., Lambert, J., Leventhal, E., Leventhal, H., Jahn, E., & Contrada, R. J. (2018). Commonsense illness beliefs, adherence behaviors, and hypertension control among African Americans. Journal of behavioral medicine, 31(5), 391. Retrieved from: https://link.springer.com/article/10.1007/s10865-008-9165-4
Nesbitt, S. D. (2019). Management of hypertension in African-Americans. US Cardiology, 6(2), 59-62. Retrieved from: https://www.uscjournal.com/articles/management-hypertension-african#:~:text=Hypertension%20is%20both%20more%20common,%2DHispanic%20whites%20at%2028.5%25.