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Hypertension in Elderly: Clinical Research Question
Aging is one of the inevitabilities of life, and it comes with physiologic decline together with high vulnerability to diseases. One of the common health complications that come with aging is hypertension. This condition is a common risk factor for different cardiovascular complications and chronic renal failure, especially in the older population. However, high blood pressure can be managed by maintaining healthy diets and an active lifestyle. This paper addresses different aspects of hypertension such as its definition, epidemiology, clinical presentation, complications, and diagnosis.
Definition
Hypertension is generally defined as unusually high levels of blood pressure. However, medical guidelines define hypertension as any blood pressure level above 130/80 mmHg (Currie & Delles, 2018). The normal blood pressure is 120/80 mmHg.
Epidemiology
The prevalence of hypertension among older people in the United States has been increasing over the years. Currently, over 63.1 percent of people aged over 60 years have at least one reported case of hypertension (Forouzanfar et al., 2017). The condition is more prevalent in women within this age group 66.8 percent of females have high blood pressure compared to 58.5 percent of their male counterparts (Forouzanfar et al., 2017). Given these figures, it suffices to conclude that hypertension is a common condition among individuals older than 60 years. This trend is set to continue on that trajectory given that the first batch of baby boomers is now turning 64 years. Therefore, in the next 5 years, the prevalence of this condition will be significantly higher than it is today.
Clinical presentation
The common clinical manifestations of hypertension include severe headaches, blurred vision, chest pain, irregular heartbeats, fatigue and confusion, difficulty in breathing, and blood in the urine. Others are reduced stroke volume due to excessive hypertrophy caused by increased wall tension, reduced cardiac function, and dysthymias (Currie & Delles, 2018). However, most cases of hypertension are asymptomatic even in cases of dangerously high levels.
Complications
The excessive pressure exerted on artery walls due to hypertension can damage blood vessels, the heart, and different organs in the body. If not controlled, high blood pressure leads to cardiac arrest, stroke, aneurysm, heart failure, dementia, weakened blood vessels in the kidney, visual impairment due to torn or narrowed eye blood capillaries, metabolic syndrome, and inhibited memory capacity. Given that most cases of high blood pressure are asymptomatic, close to 20 percent of cases are fatal. In 2014, heart attacks associated with hypertension were the leading cause of death in the US where 410,000 individuals lost their lives (Forouzanfar et al., 2017).
Diagnosis
The status of ones blood pressure is determined using a pressure-measuring gauge attached to an inflatable arm cuff around the arm. The obtained reading has two numbers expressed in millimeters of mercury (mmHg). The first reading measures the systolic pressure (arterial pressure when the heartbeats). On the other hand, the second reading measures the diastolic pressure (arterial pressure between heartbeats). Normal blood pressure is 120/80 mmHg. Any reading with a systolic pressure of 121-129 is termed as elevated pressure. Stage 1 hypertension has a systolic pressure of 130-139 mmHg, while severe hypertension has pressure readings of >140/>90 mmHg.
Conclusion
Hypertension is a common health condition among people aged over 60 years. It is associated with different complications including heart failure and stroke among others. However, the condition can be managed through different strategies. PICOT question (P) In elderly patients of 60-75 years old suffering from hypertension, (I) do patient education intervention like routine 30-minute walks and healthy diet, (C) compared with only medication treatments, (O) increase their health literacy about their diseases and improve their health status (T) in 6 months?
References
Currie, G., & Delles, C. (2018). Blood pressure targets in the elderly. Journal of Hypertension, 36(2), 234-236.
Forouzanfar, M., Liu, P., Roth, G. A., Ng, M., Biryukov, S., Marczak, L., & Murray, C. J. (2017). Global burden of hypertension and systolic blood pressure of at least 110 to 115 mmHg, 1990-2015. JAMA, 317(2), 165-182.
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