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Name: Anto John
Student No: 220188773
Unit: HSNS 263
Unit Coordinator: Rikki Jones
Due Date: 05/05/2019
Word Count :1050
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Hypertension is a chronic disease condition, which occurs by an increase in the blood pressure.
This assignment discusses the causes, incidence, prevalence and grading systems of Hypertension in
Australia and this essay also describes Trevor and katrina’s education plan.
Hypertension is a major concern in Australia. Over the last decade the proportion of hypertension
remained stable. The World Health Organization ( WHO, 2015 ) estimated that 21% and 17% of male and
female Australians in the age group of 18 years and over had uncontrolled hypertension in 2015. In 2017-
2018, 10.6% or 2.6 million, that is one out of ten Australians, has acknowledged having hypertension
previously (Australian Bureau of Statistics [ABS], 2018 ). This results remained constant over the last
decade which were respectively 9.4% and 11.3% in 2007-2008 and 2014-2015. The ABS (2018) also
stated that the prevalence rate of hypertension among male and female were quite similar in 2017-2018
which was 10.75% and 10.7% respectively, but the hypertension proportion of males was decreased from
12% in 2014-2015 to 10.75% in 2017-2018. On the other hand , female hypertension remained the same
in both period of time . The ABS (2018) also mentioned that, 22.8% or 4.3 million, that means one out of
five Australians in the age group of 18 years and over, had measured high blood pressure in 2017-2018
which had also remained constant since 2014-2015. Here the proportion of males still dominated the
proportion of females with measured high blood pressure, which was 25.4% and 20.3% respectively. This
proportion remained the same since 2014-2015 which was 24.4% and 21.7%.
The cause for the hypertension is unknown, but people having no signs and symptoms also have high
blood pressure, even if they are feeling well (ABS, 2018). According to the aetiology of hypertension, it
is classified into two types, primary hypertension which is also known as essential or idiopathic, and
secondary hypertension (Brown et al., 2015 ). The cause for the primary hypertension is unknown, but
most of the cases are due to primary hypertension. There are several factors that can lead to primary
hypertension such as increased sympathetic nervous system, overproduction of sodium-retaining
hormones and vasoconstricting substances, increased sodium intake, greater than ideal body weight,
diabetic mellitus, usage of tobacco and alcohol consumption (Brown et al., 2015). On the other hand
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secondary hypertension is due to the increase in blood pressure and this type of blood pressure can be
identified and corrected. The causes for the secondary hypertension includes cirrhosis, congenital
narrowing of the aorta, drug related disorders, endocrine disorders, ne urological disorders, pregnancyinduced hypertension (Brown et al., 2015)
According to Heart Foundation Guidelines in Australia (n.d), the guidelines for the management and
diagnosis for the hypertension is governed by Kidney Health Australia, National Stroke Foundation and
the High Blood Pressure Research Foundation of Australia. The grading system of hypertension and
blood pressure in adults are categorises hypertension into different categories namely optimal, normal,
high-normal, grade -1 (mild ) hypertension, grade-2 (moderate) hypertension, grade -3 (severe )
hypertension and isolated systolic hypertension (Anderson et al., 2016). In optimal blood pressure, the
systolic and diastolic pressure is less than 120 and 80mmHg, whereas in normal and high -normal,
systolic ranges between 120- 129mmHg and 130-139mmHg and the diastolic ranges between 80-
84mmHg and 85-89mmHg respectively. However, in the different grading system like grade 1, 2, 3
hypertension, the systolic blood pressure includes 140-159, 160-169 and greater 180mmHg; moreover the
diastolic blood pressure includes 90-99, 100-109mmHg and greater than 110mmHg respectively
(Anderson et al., 2016)). Mild hypertensions are occur due to poor life style activities such as poor diet,
lack of physical exercise, smoking and alcohol consumption. According to the case study of Trevor he
was suffering from Grade 1 hypertension. When he was brought to the hospital on first day his blood
pressure was 143/87 and became 155/92 on the third day. The primary management for the grade 1
hypertension is to reduce the blood pressure by a proper life style ( Wang et al, 2015 ), However for mild
hypertensive patient with the risk of cardiovascular disease, anti hypertensive drugs should be given
along with lifestyle modification (Gabb et al., 2016). In moderate hypertension, more intense treatment
needs to be given to reduce the blood pressure to a normal level. For reducing the hypertension,
pharmacological medications like angiotensin converting enzyme inhibitors (ACE) and beta blockers are
given (Anderson et al., 2016). In severe hypertension, the blood pressure is elevated and the risk for
cardiovascular event get increases (Anderson et al., 2016). In grade 3 hypertension, if the blood pressure
is more than 180/110 mmHg, this stage is termed as a hypertensive urgency. In this stage, the condition
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will not be life threatening, but will show symptoms such as severe headache and Hypertensive urgencies
should be treated with hypertensive oral drugs and need to be follow-up within 2 days ( Anderson et al.,
2016). Primary management for severe hypertension is hospitalization, blood pressure monitoring and
parentral antihypertensive drug therapy is conducted (Anderson et al., 2016). In Isolated systolic
hypertension, the systolic blood pressure is more than 140 and diastolic is less than 90. The isolated
systolic hypertensions include primary and secondary medications. Primary medications include thiazide
diuretics, and calcium channel blockers ,where as secondary medications include Angiotensin –
Converting inhibitors or Angiotensin receptor blockers (Bavishi, Goel & Messerli, 2016 ). There are two
risk factors for the development of hypertension namely modifiable and non modifiable hypertension. The
modifiable risk factors can be changed or controlled. This includes smoking, diet, weight control, obesity,
exercise, alcohol intake, and recreational drug use. The non modifiable lifestyle factors include age, sex
and ethnicity which cannot be changed or modified (Anderson et al., 2016). In Trevor case he belongs to
several modifiable risk factors such as smoking, breathlessness, lack of exercise and poor diet. Moreover,
he has body weight of 122kg and height of 72cm ,hence his Body Mass Index is 41.2 and he belong to
class 3 obesity (Anderson et al., 2016 ). From above these discussion, it can be concluded that Trevor is
in risk of hypertension.
Finally, hypertension is a major and the most frequent chronic disease in Australia. The assessment
and diagnosis of a hypertensive patient require well organized management plan to prevent the risk of
hypertension like heart failure or other cardiovascular disease.
Appendix
Education Plan for Trevor:
| Education Topic | Goals of health and Education | Experts/resources/multidiscipli nary team members |
Reference |
| Physical Exercise | – Accumulate 150-300 minutes of moderate intensity or 75-150 minutes of activity each week – In each week atleast 72 hrs of muscle strengthening activity |
– Australia’s physical activity and sedentary Behaviour Guidelines and the Australian 24-Hour Movement Guidelines. – Australian Cardiovascular Health and Rehabilitation Association (ACRA). |
(The Department of health, 2014) (Woodruffe et al., 2015) |
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| Smoking cessation | – Support for behaviour changes to – remain smoke free – Measuring of nicotine dependence using validated tool – Nicotine Replacement Therapy by General Practitioner |
– Quitline- 13QUIT (13 7848) – General Practitioner (GP) – Australian Cardiovascular Health and Rehabilitation Association (ACRA) |
(Woodruffe et al., 2015) |
| Control of Weight | -Waist circumference should be less than 94cm for males – Body Mass index need to be less than 25kg/m2 -Encourage Healthy Foods |
NHMRC Clinical practice guidline for the management of overweight and obesity in adults, adolescents and children in Australia,2013 -Referral to General Practitioner -Referral to Dietician -Australian Cardiovascular Health and Rehabilitation Association (ACRA) |
(National Health and Medical Research Council [NHMRC], 2013 (The Royal Australian College of General Practitioners [RACGP], 2015 (Woodruffe et al., 2015) |
| Diet | – Total fat account for 20-35% of energy intake – Salt intake should not more than 6 g/day for primary prevention and for secondary prevention the salt to 4 g/day – Five serves of vegetables and two serves of fruit daily. |
– NHRMC Australian dietary guidelines, 2013 – SNAP, 2015 |
(National Health and Medical Research Council [NHMRC], 2013 (The Royal Australian College of General Practitioners [RACGP], 2015 |
| Medication | – Glyceryl trinitrate – to reduce the blood pressure – Metoprolol- to reduce chest pain and blood pressure. – Clopidogrel- to prevent the blood coagulation. – Aspirin- act as a antiplatelet |
– www.aci.health.nsw.gov.au – General Practitioner (GP) – Pharmacist |
(Anderson et al., 2016). |
| Life long Management |
– Make a strategy with the patient along with the family for long term maintenance – day to day monitoring of blood pressure and diabetes. |
– General Practitioner – Registered Nurse -Occupation Therapist |
(Woodruffe et al., 2015) |
| Management of Blood Pressure |
– Control the blood pressure within a normal range |
– Referral to Nutritionist -Referral to General Practitioner |
(Anderson et al., 2016). |
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| – Encourage healthy diet and Excerise -In order to achieve target blood pressure Antihypertensive should be administrate. |
-National Heart Foundation Australia: Guidelines for diagnosis and management of hypertension in adults |
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| Control of Blood Sugar |
– Control of Blood Glucose level (BGL) -Educate patient with the measurement of BGL, medication administration, diet and exercise -5-10% weight loss for people with obese and type 2 diabetes |
– National Evidence Based Guideline for patient education in Type 2 Diabetes. – Referral to General Practitioner -Referral to Registered Nurse and Lab Technician -Referral to Dietician. -RACGP General practice management of type 2 diabetes |
(The Royal Australian College of General Practitioners [RCGAP], 2016 |
Education Plan for Katrina :
| Education Topic | Goals of health and Education |
Experts/resources/multidisciplinary team members |
Reference |
| Antibiotics | – For the primary prevention of Acute Rheumatic fever penicillin is usually administrate – Antibiotics should be taken for 24 hrs, in order to eliminate the transmission of Streptococcal pharyngitis. |
– RHDA Australia: The Australian guideline for prevention ,diagnosis and management of acute rheumatic fever and rheumatic heart disease. -CDC, Centers for disease Control and prevention – General Practitioner – Pharmacist |
(RHD Australia, 2012) National center for immunization and respiratory Diseases [NCIRD], 2018) |
| Sore throat Infection |
– Need to practice good hand hygiene – Avoid close contact with cold or upper respiratory infection peoples – Avoid smoking and exposure to second hand smoking |
– CDC, Centers for disease Control and prevention. -General Practioner – |
National center for immunization and respiratory Diseases [NCIRD], 2018 |
| Good hand Hygiene | -Reduce the spread of streptococcal pharyngitis |
– CDC, Centers for disease Control and prevention. |
National center for immunization and respiratory Diseases [NCIRD], 2018 |
| Routine Echocardiography |
-To exclude the presence of rheumatic carditis |
-CDC ,Centers for disease Control and Prevention – General Practitioner |
National center for immunization and respiratory Diseases [NCIRD], 2018 |
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| Diet | – Free Fluids – Normal diet – Early diet can be advice in order to avoid the weight gain |
– NHMRC Clinical practice guideline for the management of overweight and obesity in adults, adolescents and children in Australia,2013 – RHDA Australia: The Australian guideline for prevention ,diagnosis and management of acute rheumatic fever and rheumatic heart disease -Referral to General Practitioner -Referral to Dietician |
(National Health and Medical Research Council [NHMRC], 2013 (RHD Australia, 2012) |
| General care | -Bed rest -Involvement of family in caring the rheumatic fever patient – Transfer the patient to primary care facility . – Follow up the patient regularly. |
– RHDA Australia: The Australian guideline for prevention ,diagnosis and management of acute rheumatic fever and rheumatic heart disease -Registered Nurse |
(RHD Australia, 2012) |
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References
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