By Kristen Reckelhoff, Morgan Hacker

BSN Students

University of Southern Indiana

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In America, it estimated that 29 to 31 % of adults are living with hypertension. A commonly used term for hypertension is high blood pressure.  Also, due to the aging Baby Boomer population, the number of older adults with high blood pressure is expected to increase (Basile & Bloch, 2016).    The purpose of this article is to define blood pressure and high blood pressure, list risk factors for high blood pressure, identify ways to prevent high blood pressure, and discuss complications which can occur from high blood pressure.

According to the National Institutes of Health (2015), “blood pressure is the force of blood pushing against the walls of the blood vessels as the heart pumps.” Two numbers are recorded for blood pressure.  The top number is the systolic pressure which represents the force of the blood pushing against the blood vessel wall as the heart contracts.  The bottom number is the diastolic pressure which represents the force of blood pushing against the blood vessels as the heart relaxes.

The Joint National Committee (JNC) publishes guidelines every few years to help healthcare providers identify at what point blood pressure is considered to be high. Healthcare providers may refer to high blood pressure as hypertension.  Doctors may provide care based on the Joint National Committee Eighth Guideline (JNC 8).   It is important for individuals to consult with a healthcare provider to determine blood pressure goals as the guidelines may not be appropriate for everyone. The JNC 8 guidelines for blood pressure are individualized and population focused.  The JNC 8 Guidelines are listed below.

  • For people 60 years and older, the desired BP is <150/90.
  • For people younger than 60 years and healthy, the desired BP is <140/90.
  • For people of any age who have Chronic Kidney Disease or Diabetes, the desired BP is <140/90.
  • High BP is anything at or above the targeted BP ranges listed above for the specific populations (Basile & Bloch, 2016).

 

There are some factors that increase one’s risk of developing high blood pressure.  The most common form of high blood pressure is called primary hypertension (Basile & Bloch, 2016).  This type has no clear cause and tends to develop as one ages.  The risk factors for high blood pressure are listed below.

  • Family history (especially parents, siblings, or children with hypertension)
  • African-American ethnicity
  • Age older than 60 or post-menopausal women
  • Smoking
  • A diet high in sodium
  • Caffeine intake
  • Excessive alcohol intake
  • Being overweight
  • Physical inactivity
  • High cholesterol
  • High stress (Basile & Bloch)

Another type of high blood pressure is secondary hypertension.  This type is caused by another medical condition or medication use and is usually resolved after the condition is treated or the medication is stopped.  Some of the medical conditions and medications that cause secondary hypertension are listed below.

  • Chronic kidney disease
  • Adrenal disease
  • Thyroid problems
  • Medications
    • Anti-depressants
    • Decongestants
    • Weight loss medicines
    • NSAIDS (ibuprofen & aspirin)
    • Tylenol
    • Hormone replacements (Basile & Bloch, 2016)

 

With these known risk factors, it is important to understand the steps individuals can take to prevent their chances of developing high blood pressure.  By adopting these lifestyle changes recommended by the National Institutes of Health (2015), one can greatly reduce the risk of developing hypertension.  If obese or overweight, losing even 10 pounds can lower one’s blood pressure.  A healthy weight is considered a body mass index (BMI) between 19 and 25.  Participating in exercise or physical activity three or four days per week for about 30 minutes can also help lower high blood pressure.  A simple way to do this is by walking.  A healthy diet is  important in maintaining a normal blood pressure.  A well-balanced diet contains a variety of fruits, vegetables, whole-grains, low-fat dairy products, fish, poultry, legumes, and nuts.  In addition, individuals should limit their salt intake to 1500-2400 mg per day.  Therefore, it is important to read food labels carefully to check the amount of salt or sodium they contain.  Typically, processed meats, canned soups and vegetables, pre-packaged foods, and items from fast-food restaurants have high sodium content.  Try to use alcohol sparingly.  Men should drink no more than two alcoholic drinks per day.  Women should have no more than one alcoholic drink per day.  Along with these diet changes, it is important to avoid caffeine and to stop smoking, because these substances can constrict the blood vessels, which increases the blood pressure.  Stress contributes to high blood pressure, so participating in stress reducing activities such as yoga and meditation can be beneficial.  Getting a good night’s sleep also plays a role in reducing blood pressure.  It is recommended to get eight hours of sleep per night.  Lastly, it is important to get annual blood pressure screenings to track trends in blood pressure (National Institutes of Health).  There are multiple business locations in the Evansville area that offer free blood pressure checks, some of which include Wal-Mart, Walgreens, and CVS.  In addition, there are certain locations in Vanderburgh County that offer free blood pressure screenings to the public.  Dates, times, and locations of these free blood pressure screenings in the Vanderburgh County area can be found on www.evansville.in.gov.

 

Over time, continuous high blood pressure can cause multiple serious complications.  Heart failure can result, because the heart has to continually work harder to push the blood forward when the pressure in the system is high (National Institutes of Health, 2015).  High blood pressure can also cause the blood vessels in the kidneys to narrow, which can lead to kidney failure.  In addition, the elevated pressure can make the arteries hard and stiff, which can cause a heart attack, stroke, or peripheral vascular disease.  Lastly, if high blood pressure goes untreated for a long period of time or gets extremely high, it can result in death.

 

 

In conclusion, high blood pressure is a very common issue, especially in the older adult population.  There are many factors that can affect the blood pressure.  Some of these risk factors can be reduced, and in turn, prevent one’s chance of developing high blood pressure.  Other risk factors, such as age and ethnicity, cannot be changed.  Preventing the onset of high blood pressure will keep complications from developing and lead to better overall health.  It is important to ask for advice from a medical professional when considering diet or lifestyle changes to prevent high blood pressure.

 

Kristen Reckelhoff, BSN Student

Morgan Hacker, BSN Student

Pam Thomas, MSN, RN, CCRN

Charlotte Connerton, EdD, RN, CNE-BC

University of Southern Indiana College of Nursing and Health Professions

 

References

Basile, J., Bloch, M. (2016).  Overview of hypertension in adults. In G. Bakris, N. Kaplan & J. Forman (Eds.), UpToDate.  Retrieved from www.uptodate.com

National Institutes of Health. (2015). High blood pressure. Retrieved from http://nihseniorhealth.gov/highbloodpressure/whatishighbp/01.html