Hypertension in Hispanic population

Abstract

Purpose/Objective: The purpose of this paper is to develop a suitable medication and caring plan for the Hispanic population In USA. The study looks to encourage the hospitals and the medical agencies in the country to develop a suitable plan for the growing concerns of hypertension syndrome among the Hispanic population.

Background/ Rationale: Hypertension has been one of the most recurring diseases in the US and with careful analysis it has been found that most of it has been caused by unhealthy lifestyle. The National Medical Authorities have developed a general guideline for the treatment of hypertension but nothing has been done for the unique cultural groups residing in the country. Among the minority groups, it has been found that the Hispanic population is on the rise and the hypertension disease has been a significant impact on the population. Therefore, a suitable guideline should be developed for this cultural group at the earliest to arrest the development of the disease.

Description of the Project / Innovation: This project will take the help of JNC-7 and JNC-8 Guidelines that have been developed by the National Authorities. In addition to this the paper has taken the help of Watson’s Caring Model that have been analyzed to be best suited for the treatment of patients with unique backgrounds. It has to be noted that Hispanics are parts of a unique cultural group and thus they have to be treated in a different way than that of the other groups in the country.

Interpretation/ Conclusion: It has been found that with careful implications of the JNC-7 and JNC-8 Guidelines and with the development of the Caring Model, hypertension aspects in the Hispanic population can be curbed to some extent. It can be managed at an early stage with the development of communication and information aspect among the Hispanic population.

Implications: The study has underlined the fact that the Hispanic population is a unique part of the society and the culture and lifestyle of the race is unique to the other groups of USA. In addition to this, it has also been found that some parts of the Hispanic population are undocumented residents in the country and thus are not entitled to receive medicinal benefits of the Government. In this condition, it has been very difficult for the Government Authorities to develop a proper treatment plan for the Hispanic population.

The adulterated lifestyle of the Hispanic population and indiscipline in their daily life also make them vulnerable to the hypertension disease and thus it has been a big threat to the US population. Thus, it should be taken into account at the earliest and the Government and the medicinal authorities should make it a point to develop a proper treatment plan. Proper communication is necessary to curb the disease at an early stage and the treatment plan in terms with the JNC-7 and JNC-8 Guidelines should be communicated. The paper has found that for the development of a proper treatment plan for the hypertension disease, it is necessary for the general populace to follow Active Management of Diet and Exercise and Active Pharmacological Management. This will help the prospective patients to develop an immune system to the disease to a certain extent. In addition to this, it is also the responsibility of the Government and the medicinal authorities to communicate the benefits of the above to the populace. In addition to this, the medicinal authorities should develop a proper follow up care model that has been prescribed in the study. Modern day technologies can be used for the development of hypertension treatment and information regarding the treatment aspects can be available in the modern day gadgets. The medical facilities should be developed in the nooks and corners of the country so that the Hispanic population can avail them for their benefits. Still, effective and accessible education on hypertension is only the first step toward achieving positive health care outcomes in the Hispanic American population. There must be more active means of promoting lifestyle management among Hispanic Americans toward recognizing and preventing the dangers of hypertension. In this case, it has to be stated that the Hispanic population should be communicated about the dangers of hypertension as well as the benefits of leading a healthy lifestyle. The health officials should take the responsibility to communicate with the Hispanics at every level of society.

 

 

 

 

 

 

 

 

 

 

Purpose

Hypertension has been one of the most recurring diseases that have been affecting Americans in the present era. According to the Centers for Disease Control and Prevention (CDC), about 67 million Americans have been suffering from this disease and most of the affected have not been able to manage the conditions. (The Centers for Disease Control Website, 17th September, 2012). Though there have been a huge development in the educational and informatory resources in the present days, still there have been parts of population who are not aware of the things that are needed to be done in these conditions.

One of the most affected parts of the American population is the Hispanics. The Hispanic population has been one of the fastest growing ones in the US. (Guzman, 2012, p. 165). The Hispanic population consists of the immigrants from the countries like Mexico, Central America, and South America (Ennis, Rios-Vargas, & Albert, 2011, p. 2). In some of the states like California and Texas, the Hispanics consist of a major part of the total population. In fact, the Hispanic population of these two states consists of 47% of the total Hispanic population in the entire USA. (Ennis, Rios-Vargas, & Albert, 2011, p. 7).

It has to be noted in this regard, that the lifestyle of the Hispanics makes them vulnerable against the disease. Unhealthy lifestyle and indiscipline in their food habits make hypertension common among the Hispanic population. It is also quite interesting to note that despite being one of the most prominent races in the nation, the Government has done little to improve the situation of the Hispanics in terms of their health aspects. Despite this surge in the population of Hispanics, there are “currently no hypertension treatment guidelines that address the unique characteristics of this ethnic group” (Guzman, 2012, p. 165). Hypertension is a common and underlying risk factor for morbidity and mortality in the world today, and it is considered to be the most important and modifiable risk factor for coronary heart disease, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease (Patronis-Jones, Ricard, Sefcik, & Miller, 2001, p. 36); as such, the lack of hypertension awareness and effective blood-pressure control techniques have led to an increase in diabetes, cardiovascular disease, and other diseases associated with hypertension (Aponte, 2009, Guzman, 2012, Zallman, et al., 2013).

The paper will thus look to find out the trends of the Hispanic population and the factors that make them vulnerable to hypertension aspects. It has to be noted that America on the whole has been affected to a certain extent by the disease and there have been certain measures taken by the Government and the health bodies to improve the situation. However, there have been no measures of such in terms of the Hispanic population and given their unique lifestyle, it is important that proper measures are taken in this aspect. The paper will investigate the aspects that can be taken into account in improving the situation particularly for the Hispanic population in the US. The paper will also look to implicate a nursing model that will be best suited for the situation. This will help the paper to move to certain conclusions that will help in the development of a roadmap to cure the problem for the Hispanic population.

Background of the study

As has been stated in the earlier part of the paper, hypertension has grown to be one of the most important health issues in the US today. It is a chronic illness that has been affecting 1 out of every 3 Americans today. It is a myth that hypertension affects old and elderly and results have shown that there are high chances that young people get affected with this disease. (Sheps, 2nd November, 2012).

A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects. The term chronic is usually applied when the course of the disease lasts for more than three months. Chronic diseases have been affecting population worldwide and in the US, it has been responsible for most of the diseases and deaths. Hypertension is a common and underlying risk factor for morbidity and mortality in the world today, and it is considered to be the most important and modifiable risk factor for coronary heart disease, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease (Patronis-Jones, Ricard, Sefcik, & Miller, 2001, p. 36); as such, the lack of hypertension awareness and effective blood-pressure control techniques have led to an increase in diabetes, cardiovascular disease, and other diseases associated with hypertension (Aponte, 2009, Guzman, 2012, Zallman, et al., 2013).

Thus, hypertension can be defined as a sustained level of elevated blood pressure which is asymptomatic in majority of the patients.

Classification of Blood pressure

Category                                SBP                                         DBP mmHg

Normal                                    <120                and                  <80

Prehypertension                      120-139           or                     80-89

Hypertension, Stage 1             140-159           or                     90-99

Hypertension, Stage 2             ≥160                or                     ≥100

Hypertension occurs in approximately 20% – 25% of general population.

It has been found that hypertension generally affects people with unhealthy and indiscipline lifestyles. In addition to this, lack of education, problems with diagnosis, communication problems etc also affects in developing hypertension. The risk with the Hispanic population lies in with the fact that they come from different cultures and from a different country. Their lifestyles are completely different from that of the American population and their activities in the social sphere make them unique propositions in the country.

It has been found that about 18% of the Hispanic population suffers from hypertension and the major reasons for this has been the lifestyle they tend to lead in the society. In addition to this, the lack of education and the communication problems have also been major issues that have been influenced the growth of this disease in the Hispanic race. The differences in language and socio-cultural traits in the Hispanic population with the other parts of the American society make it difficult for the measures put up by the Government and the health organizations to be implemented in them. Therefore, it has been seen that the Government and the health bodies of the country have not developed any specific policies for the Hispanic race in the US and this is the reason why the conditions have been deteriorating day by day. Therefore, it will be beneficial that the Government and the health bodies look to take control of the situation at the earliest and develop policies that will look to control the occurrence of this disease in the Hispanic population.

Description of the project

The project has taken note of the problems that have existed in the Hispanic population in the US and have tried to find the reasons behind it. It has to be noted here that these aspects are necessary as this in turn will help the paper to develop a viable conclusion and will also help the paper to develop a persistent road map to address the problem.

The section will look to find out the causes of hypertension and the salient features of the Hispanic population in the US. It will also look to find out the modes of treatment that can be provided to the population in accordance with the Health Guidelines of the country.

Hispanic lifestyle education and modifiable risk factors

Hypertension can be influenced by static factors like the sex, age and the genetic aspects of an individual. (Patronis-Jones, Ricard, Sefcik, & Miller, 2001, p. 36). These aspects cannot be modified and are exclusive of the positive health outcomes that can be followed to remove the occurrence of hypertension. However, lifestyle aspects have a major impact on the occurrence of hypertension and education plays an important role. In addition to this, modifiable risk factors include the weight of the individual, smoking and drinking habits, sodium intake etc. It has to be noted that these aspects can be modified to some extent by the individual and thus hypertension can be controlled to some extent.

One of the major reasons for the development of the hypertension aspects have been the obesity and the excessive body fat. These aspects are influenced by unhealthy lifestyles of the population. The obesity and body fats influence the blood pressure (BP) level to rise in the body which causes hypertension. According to The U.S. Department of Health and Human Services (HHS), 78% of the Hispanic women can be considered overweight and obese. (The Office of Minority Health Website, 2013). In contrast, 60.3% of the White women population in the US can be considered as overweight. The situation further worsens with the fact that 30% of the Hispanic adult population is less likely than that of the White population to participate in any physical activity. (The Office of Minority Health Website, 2013).

HHS also suggests that the Hispanic population has suffered due to the lack of lifestyle education. The Hispanic population is unaware of the various aspects that can improve their health and this has influenced the growing trends of obesity among the population. In some cases, they are unaware of the benefits of exercises and this has led to the prevalence of hypertension among them. (The Office of Minority Health Website, 2013). The study conducted by HHS underlined the fact that only 56.7% of the Hispanics were informed and advised medically about foods lower in fats and cholesterol. (The Office of Minority Health Website, 2013). The study underlines the fact that lack of education has affected the lifestyle of the Hispanic population to a certain extent and this has influenced their lack of knowledge about the quality of the foods they intake.

Sodium intake among Hispanics in America is also a notable risk factor for hypertension that can be modified by lifestyle; a 2012 study by the Centers for Disease Control (CDC) identified a correlation between high sodium intake and increased risks of hypertension particularly in Hispanic children and adolescents (The Centers for Disease Control Website, 17th September, 2012). Further, the study found that high sodium intakes and the risk for high blood pressure increased greater in overweight and obese children. In response, the CDC warned people that they should read food and health labels before consuming foods and to increase their intake of fresh fruits and vegetables in their diet; they also warned against eating too many processed foods and restaurant-styled foods, which are higher in sodium (The Centers for Disease Control Website, 17th September, 2012). They specifically recommended that children without diabetes and high blood pressure should limit intake of sodium to less than 2300 mg per day, while children with diabetes and high blood pressure should limit intake to 1500 mg per day. If the suggestions of the research by the HHS are valid, it would follow that addressing hypertension in Hispanic communities would require transferring these findings and recommendations on sodium intake into effective and accessible lifestyle education (The Office of Minority Health Website, 2013).

Smoking has been another factor that can affect the recurrence of hypertension. However, according to the American Lung Association (ALA) (2010), smoking is a modifiable lifestyle factor. According to ALA, occurrence of smoking is lesser in the Hispanic American population than that of the other minority groups. A research by ALA found that only 20.7% of the Hispanic men and 10.7% of the Hispanic women smoke. However, among the Hispanic women, the Puerto Rican Women had double the chances of smoking than that of the other Hispanic women. Thus, it can be stated that Hispanic population in general have lesser chances of hypertension caused by smoking but there may be higher chances in various subgroups of the Hispanic population. (The American Lung Association, 2010).

Another aspect that have affected the growth of hypertension in general has been the intake of alcohol. (Sheps, 2012). According to Dr. Sheldon Sheps of the Mayo Clinic, drinking excessively for an extended period of time can increase high blood pressure and increase the chances of long-term illness (Sheps, 2012). His suggestion is that adults under the age of 65 limit their drinking to 2 servings of alcohol per day and people over 65 to only one serving per day. However, it has been found that Hispanic men and women exceed this recommended serving of alcohol per day. A study by Alcohol Health and Research World in 1998 underlined the fact that the rate of alcohol intake may vary between the various sub groups of Hispanic population. It has been found that the Mexican men are more prone to drinking than that of the other groups of the Hispanic population. (Caetano, Clark, & Tam, 1998). Thus, taking cue from the study put forward by the HHS, it can be stated that the elimination of the alcohol risks can be developed with the help of proper lifestyle education.

The section has stated that hypertension can be caused by unhealthy lifestyle and the lack of education among the population. It has been seen that majority of the risks associated with the growth of hypertension aspects can be negated and modifiable. However, this will require education among the population and awareness about the health aspects. The health bodies and the Government should develop recurring policies that would affect all ages and levels of population and will inform them about the risks associated with unhealthy lifestyle. The Hispanic population has been affected by these aspects as they have been more prone to the unhealthy lifestyle as well as there has been a lack of general education among the group.

Problems of diagnosis

Till date there has been no specific guideline for the treatment of hypertension in the Hispanic population. However, there have been studies that took account of the health care efforts that have been pursued in the treatment of hypertension and it has been found that ineffective treatment and care has been one of the major reasons for the growth of the disease. (Guzman, 2012, p. 165).

In a 2001 study of the demographics of hypertension that appeared in the journal Hypertension and Holistic Care, people of Hispanic descent were compared with non-Hispanic people in southern Texas; it was found that reported incidents of high blood pressure among Mexican-Americans was comparable to the national average, but the number of Mexican-Americans who were actually aware of their hypertension was much lower than the national average (Patronis Jones, Ricard, Sefcik, & Miller, 2001). This suggests a notable absence of effective diagnosis. Unawareness of hypertension among Hispanics also varied by state; while 53% of those diagnosed in south Texas were previously aware of their condition, up to 71% of those diagnosed in New York were previously aware (Patronis Jones, Ricard, Sefcik, & Miller, 2001, p. 41).

In 2009, a study in North Carolina examined the idea of using culturally sensitive teaching interventions for Hispanics to decrease their chances of developing hypertension (del Pilar Rocha-Goldberg et al, 2010). The study focused on 64 participants who were gathered between healthcare provided referrals, direct contact, and print media. Of these participants, 17 completed the study and had their records available to scrutinize. The results were that the participants responded favorably to the teachings, and the participants strongly agreed that the group sessions gave them the tools and knowledge needed to achieve weight loss and control their blood pressure (del Pilar Rocha-Goldberg, et al., 2010).

It should be noted, however, that responses varied with the choice of interviewer in the study. During the study, the interviewer was initially a Spanish speaker of Hispanic descent, but was later changed to a Spanish speaker of non-Hispanic descent (del Pilar Rocha-Goldberg et al., 2010). It was found that more information was given to the Hispanic interviewer; when the non-Hispanic interviewer was later replaced by another Hispanic interviewer, information flowed freely again. This would suggest that Hispanics are more comfortable speaking with health care workers who share their ethnicity; as such, the presence of Hispanic health care professionals is likely to promote effective prevention, diagnosis and management of hypertension in Hispanic communities. This parallels Guzman’s finding that “patient trust is higher when healthcare providers are of the same ethnicity as the patient and when the physician and patient can communicate in the patient’s native language” (2012).

Together, these two studies have three potential implications. First, the number of Hispanics who are aware of the dangers of Hypertension falls below the national average in the United States, although the number of Hispanics who suffer from Hypertension is close to the national average. Second, Hispanics are more comfortable speaking of their health concerns with health care workers who are also Hispanic. Third, and perhaps the most important, is that studies show that Hispanics can be taught the dangers of high blood pressure and that carrying extra body weight is directly related to developing Hypertension.

Variations of socio economic status among Hispanic population

The variations in the statuses of the Hispanic population also affect the prevalence of hypertension among the same. There has been a key distinction between the statuses of the Hispanic population in terms of places of their birth. One group consists of the Hispanics born in the US and thus are naturalized Americans. The other group consists of immigrants coming from other countries and may be naturalized immigrants or undocumented immigrants. (Aponte, 2009). This key distinction is correlated to the access of Hispanics to health care measures to prevent, diagnose, or manage hypertension, where the foreign born, undocumented Hispanics are least likely to have access to measures and insurance (Aponte, 2009).   Those who are naturalized American citizens of Hispanic descent are more likely to have insurance and are more likely to have been tested for hypertension; naturalized citizens are still less likely to be tested than domestically born Hispanic Americans (Aponte, 2009). In light of these findings, it can be said that socioeconomic status affects the prevalence and impact of hypertension by varying the access of Hispanics to health care measures and insurance at large.

Pathogenesis and pathophysiology of hypertension 

Over 90% of cases have no identifiable cause, thus constituting the category of primary or essential hypertension. The remaining 10% of cases have the secondary causes such as: Renal, Endocrine, Vascular, and Chemical and medication induced causes. There are some predisposing factors such as; family history of hypertension, obesity, stress, sedentary lifestyle, alcohol consumption, male Gender, age over 30 years, excessive salt intake, medication, and drug use.

Remedies to be brought forward

The review of the literature has underlined the fact that there have been no measures taken by the health bodies and the Government of the country in the treatment of hypertension occurrence among the Hispanic population. However, there have been certain guidelines developed by the National Health Bodies in order to control the recurrence of hypertension. The most important among them are the JNC-7 and JNC-8 guidelines.

The JNC-8 guidelines started to develop in 2009. (James, 2013). More than 400 nominees were selected from a pool of hypertension experts in primary care, nursing, and pharmacology. Of these nominees, 48 were selected to become the panel that would draft the JNC-8 recommendations on the treatment of hypertension, and this panel examined the recommendations for nearly four years. They released their recommendations to 20 reviewers and 16 federal agencies in January of 2013; the anonymous reviews were discussed by the panel for over three months, and the contents were incorporated into a revised document that was released in December of 2013 (James, 2013).

The guidelines took shape in 2014 and consist of 9 recommendations that can be followed in the management of hypertension. The recommendations have been developed specifically for the health professionals and they have been explained in detail. In addition to this, each of the recommendation has a grade attached to it that talks about the validity of it. The results of the recommendations are graded with a letter grade of A to E plus the letter N. A stands for a strong recommendation, with B and C standing for moderate and weak recommendations. D stands for a recommendation against, while E stands for an expert opinion that is lacking evidence to support the recommendation. The letter N stands for no recommendation for or against the suggestion (James, 2013, p. 208).

The JNC-7 guidelines were developed ten years before the JNC-8 guidelines and there were subsequent differences between the reports. This is quite natural given the fact that there were tremendous advancements in the medical field over the period and there were various researches done in the field. Thus, the way the hypertension has been defined and the way it can be managed varies between the two reports. (James, 2013). In the JNC-7 report, the definitions of both prehypertension and hypertension. However, in the JNC-8 report, a guideline has been specified about the threshold period about when the treatment should begin. The JNC-7 guidelines make recommendations about the changes that are to be brought in the lifestyles of the population to take care of hypertension. However, in the JNC-8 report, the recommendations provided by the Lifestyle Work Group have been endorsed. (Martin, 2008; James, 2013).

The JNC-8 guidelines have specifically stated about the treatment plans that are to be followed in the case of the recurrence of the disease. It does not talk about the life threatening issues and the chances of death with the disease. This is because the reports have been specifically prepared for the health professionals who are well educated and knowledgeable about this aspect.

Therefore, it can be stated that the health bodies have developed some recommendations and proposals for the development of a treatment plan for hypertension issues. However, it has been general and does not take into account the salient and unique features of the minority groups in consideration. Therefore, there have been difficulties in treating hypertension cases in the Hispanic population to a large extent. In addition to this, the majority of Hispanic population has not received specialized medical advice regarding the treatment of hypertension. It is important that the health professionals working in various areas of the society take note of the guidelines and communicate them to the Hispanic population in all rungs of the society. As the Hispanic population will get education about the various factors that curbs hypertension as also induces it, they will be more responsible in their way of life.

Therefore, it is important for the development of a specific nursing care model that can help in the treatment of the Hispanic patients. Given the uniqueness of the Hispanic patients and the uniqueness of the problems they face it is important that the nurses play an important role in their care taking note of their background. Watson’s caring model can be referred in this aspect.

Caring model has been one of the most important aspects of caring science. The model encompasses the humanitarian aspects, human science orientation, phenomena and experiences. Thus, the model takes note of both art and science. The caring science perspective is based on the relational ontology of being in relation and connectedness to other aspects of life. Therefore, the background of the patient and their cultural as well as mental aspects are to be taken note of in this model. Caring science also involves in moving on to new fields of patient’s mental health and involves inquisitiveness about “aesthetic, poetic, narrative, personal, intuitive, kinesthetic, evolving consciousness, intentionality, metaphysical – spiritual, as well as moral-ethical knowing.” (Watson Caring Science Institute, 2014). Therefore, the important aspects of the model can be stated as follows:

  • Caring for self and others that involves the analysis of the background of the patient
  • Transpersonal caring relationships
  • Developing caring moments
  • Multiple ways of knowing
  • Reflective approach that involves analysis of the self behavior as well as the analysis of the mental aspects of the patients (Wagner, 2010).

The model defined 10 caritas processes that can be stated as follows:

  • Practicing of loving and kindness
  • Instilling faith and hope and honoring others
  • Being sensitive to the background of others by honoring their beliefs
  • Help-trust-care relationships
  • Acceptance of positive and negative aspects while listening to others
  • Use of scientific caring methods for decision making
  • Develop teaching and learning that suits the varying needs of the individuals
  • Development of a healing and spiritual environment that respects the human dignity
  • Assistance of the patients with the basic emotional, spiritual and physical human needs
  • Openness to any new happenings and mystery in medical science (Watson Caring Science Institute, 2014).

It can thus be stated that caring of the individual has been one of the most important aspects of the model. However, caring in the terms of the model will encompass taking note of the spiritual, emotional and mental health of the individual and listening to them attentively. Communication and listening has been important parts of the model and this helps in finding out the problems of the patients in detail. Care should be taken not to hurt the feelings in any way and this increases the trust shown by the patients.

In the case of the Hispanic population, the fact that they are quite different in their backgrounds in relation to the other groups of population in the US makes it relevant to be treated by this model. There may be problems of communication which cannot be solved unless the nurses are equipped with capacity to listen. This will underline the real problem of the patients and will help the medics to perform their treatment in a better way. It is also important for the nurses to evolve a sense of trust among the patients and thus they will assist in their treatment.

Summary

The literature review has underlined the fact that there are various causes that gives impetus to the growth of hypertension. Some of them cannot be modified and are not parts of the review. However, there are some modifiable characteristics that can be taken into account. It has been found that lifestyle characteristics and education have been the major aspects that can play a vital role in the recurring bouts of hypertension. Smoking, drinking, lack of exercise etc have played an important role in developing unhealthy lifestyle and this in turn can play a vital role in the development of hypertension in the adults. The Hispanics have been found to be prone to this disease as they are unaware of the quality food habits as well as are prone to not exercising. The lifestyles they lead in the American society also play an important role in the development of the disease.

In addition to this, there have been problems of diagnosis among the Hispanic population due to the problems of language and communication. In addition to this, as the Hispanic population is unaware of the negative aspects of hypertension, they do not report to the medics in most cases. The social statuses of the Hispanic population vary depending on their legality of the naturalization to the American soil and this may affect the treatment of the disease to a large extent.

It has been found that the Government and the health bodies have not been able to develop a specific plan for the Hispanic population and it has to be done at the earliest to take care of the unique problems the race is facing at the moment. The treatment should be formulated in accordance with the JNC-8 guidelines and this has to be communicated to the Hispanics in every part of the society. In addition to this, the health authorities at lower level should play a vital role in communicating with the Hispanics and stating them about the unhealthy lifestyles and the negative aspects of hypertension. A specific nursing model on the lines of Watson’s caring model should be developed that take care of the background of the patients and honor their uniqueness in most aspects. It has to be noted that the Hispanic population is unique in some way or the other and special care should be taken not to hurt their feelings and practices during the treatment. This would help in the development of treatment aspects to a large extent.

Interpretation

The paper up to now has stated about the various aspects of hypertension and its influence on the Hispanic population. It cannot be denied that the Hispanic population occupies a significant place in the society of the US today and proper care has to be taken to ensure their proper health and development. However, it has also be taken in mind that the Hispanic population is unique in its background and social norms and practices and thus respect and honor should be given to them.

It has been found that the hypertension aspects have been influenced by unhealthy lifestyles and this has been seen in abundance in the Hispanic race. Thus, specific implementations to be discussed include managing diet and exercise regimens, thorough anti-hypertensive drug education, and follow-up care for clients and families, anti-hypertensive technologies, and clinical outreaches for those lacking access via insurance.

Active Management of Diet and Exercise

Non-pharmacological management of hypertension via diet and exercise should be prescribed by nurse practitioners and followed up by registered nurses. By adjusting the diet and exercise regimen of Hispanics, Nurse Practitioners can have a great impact over the life-long health care of their patients. Studies have shown that controlling the weight of the patient can decrease the chances of developing cardiovascular disease (Aponte, 2009, Patronis Jones, Ricard, Sefcik, & Miller, 2001, Guzman, 2012).

Active Pharmacological Management

Pharmacological management of hypertension can also be enhanced with efforts of active communication. A trend among Hispanics is personal cessation of prescribed medications in lieu of present symptoms, and so implementation of follow-up care may promote adherence (Guzman, 2012, Patronis-Jones, Ricard, Sefcik, & Miller, 2001, Sheps, 2012, The WebMD Website, 2013). Doctors and nurses need to make certain that the drugs that are prescribed are taken by the patients. If possible, nurses should also incorporate the client’s family into the education process; this benefits the entire family as well as the person with hypertension.

Follow-Up Care

Another benefit of active communication in follow-up care is limiting the progression of hypertension into other serious complications (Guzman, 2012, Patronis-Jones, Ricard, Sefcik, & Miller, 2001, Sheps, 2012, The WebMD Website, 2013). Doctors and nurse practitioners may ask patients with newly diagnosed hypertension to change their diet or to exercise more often in order to cut down on the ill-effects of hypertension. There are also more tests to take while visiting the Doctor or Nurse Practitioner after the diagnosis of hypertension. These tests include screening for damages to their eyes, the heart, the brain, and the kidneys (The WebMD Website, 2013). Lastly, follow-up care allows the opportunity for the practitioner to monitor hypertension and the need for dosage adjustments.

Technology

Nurse practitioners, doctors, and other health care professionals should also think about ways that they can effectively communicate with people who may not have health insurance. The Affordable Care Act of 2010 still leaves undocumented workers with less than five years of domesticity without access to health care via insurance. Therefore, ways must be discovered to reach those who are not covered by insurance in order to cut down and eliminate the disease of hypertension. One such way to do this is by using the smart phone technologies that are now becoming popular with Hispanic Americans.

Smart phones allow someone to place applications on the phone that can be customized towards what interests them. These applications can include informative, life-saving applications to the smart phone of someone in lieu of primary care access via insurance. Smart phone applications developed with doctors and nurses can help the undocumented Hispanics to independently manage hypertension and other cardiovascular ailments, self-regulate and control their dietary intake, recommend fun and exciting ways to get needed exercise, and increase in knowledge to manage hypertension. There are several applications for the smart phone user who wishes to stay on top of their high blood pressure problem or diabetes. For this technology to be maximally effective, Spanish language versions must be developed, and lifestyle recommendations for living with hypertension must be adjusted for the Hispanic user. One such application, although currently in English, is the Heart Blood Pressure Journal, Premium Edition. This application is only $4.99, and is available through the Withings website.

Clinical Outreaches

Lastly, nurses and doctors must be ready at all times to speak intelligently and passionately about hypertension, and about the risk of having high blood pressure undiagnosed in the lives of their patients. The nurse practitioner’s role in this scenario is more than just as a worker in the health field. Nurse practitioners should be proactive in their assessments of the lives of the patients. There are undocumented day laborers who do not have health care in the United States but still get ill and need a doctor. There should be investment into freely accessible clinical outreaches to screen for hypertension. In this setting, the doctor or nurse practitioner can engage clients toward effective management of hypertension. Without freely accessible communication between health care professionals and uninsured Hispanics, hypertension will remain as an undiagnosed epidemic.

Pathophysiology and spiritual, ethical, and cultural aspect

It has been stated in the earlier parts of the paper that some aspects of hypertension are related to Pathophysiology like family history of hypertension, obesity, stress, sedentary lifestyle, alcohol consumption etc. It is the duty of the medical professionals to analyze every aspect of this and make a case history of the patients. In this case to the caring model will be taken into account and proper means of communication will be useful.

The Hispanic population is unique in a way to the other social groups in USA and thus it is quite natural that they will have some unique features related to their society. It is the duty of the nurses to listen attentively to their cases and they should not hurt their feelings during the conversation. This will induce the trust of the patients among the health care. The treatment should be ethical and should take care of all the unique cultural needs of the patients. This will increase the awareness among the Hispanic population to a certain extent.

Implications

In the fight against coronary heart disease, stroke, and congestive heart failure, hypertension is primary modifiable risk factor in prevention (Patronis Jones, Ricard, Sefcik, & Miller, 2001, p. 36). Although several studies have explored obstacles to the knowledge, prevention, diagnosis, and management of hypertension Hispanics in America, other studies suggest that the teaching of Hispanics of the dangers of Hypertension is possible.

One of the most important aspects that have come forward with the help of the study is that the Hispanic population is a unique part of the culture and society of USA and thus they behave in a different manner than that of the other parts of the society. They are not as educated as that of the other parts of the society and are prone to unhealthy lifestyle. The fact that many of the Hispanics come to the country with the help of forged documents also minimize their chances of getting a better treatment. Therefore, all these aspects have to be taken into consideration to develop a proper plan in the treatment of hypertension.

Still, effective and accessible education on hypertension is only the first step toward achieving positive health care outcomes in the Hispanic American population. There must be more active means of promoting lifestyle management among Hispanic Americans toward recognizing and preventing the dangers of hypertension. In this case, it has to be stated that the Hispanic population should be communicated about the dangers of hypertension as well as the benefits of leading a healthy lifestyle. The health officials should take the responsibility to communicate with the Hispanics at every level of society. In addition to this, the medical facilities should also be able to take into consideration the uniqueness of the Hispanic race and treat them accordingly. The care model that has been stated as a part of the paper will be helpful in this as the crux of the model is based on listening and acknowledging the specific cases of the patients. The patients should be comfortable in the medical facilities and their cases should be heard with rapt attention. This will help in better treatment of the Hispanic population. This educational effort by nurse practitioners and other health care professionals can include print media and clinical outreaches, but it should also include smart phone technologies to increase access and promote positive change. As technology has been available to all and sundry in the country, the Hispanic population should feel comfortable to search for information regarding the disease. The Government should come forward and should make special efforts to reach the Hispanic population by arranging medical camps at Hispanic neighborhoods and providing information about the disease.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

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