Description Hypertension/ high blood pressure is a common condition among women. Hypertension is caused by long-term forces of blood in a patient’s artery walls, which are usually high enough to cause health problems such as heart diseases (Kitt, Fox, Tucker, & McManus, 2019). Blood pressure will therefore be determined by the amount of blood that a given individual’s heart will pump and the resistance of the blood flow that will be encountered on the arteries. The amount of blood in an individual’s body, coupled with narrower arteries, will result in high blood pressure. A patient can have hypertension for years without noticing any symptoms. However, damage to the heart and blood vessels will continue without any symptoms. Uncontrolled hypertension will thus increase the risk of stroke and heart attack (Wenger, Arnold, Bairey, Cooper-DeHoff, et al., 2018). Common Symptoms Most women who will have hypertension will not experience any signs or symptoms. However, in a small proportion of the population, high blood pressure signs and symptoms include shortness of breath, headaches, and nose bleeds. Such symptoms will occur when blood pressure reaches life threatening or severe stages. Diagnosis The diagnosis of hypertension will involve taking blood pressure measurements by a specialist or a doctor. An inflatable arm cuff is placed around the patient arms to measure the pressure of their blood through a pressure-measuring gauge (Kitt et al., 2019). A blood pressure reading is then taken, recorded in millimeters of mercury (mmHg) containing two numbers. The first number, which is the upper number, will represent the patient’s arteries’ pressure when their heart is beating. This is known as systolic pressure. The lower measurement will represent the pressure in a patient’s arteries between their heartbeats. This will be referred to a diastolic pressure (Kitt et al., 2019). The blood pressure measurements among patients will fall into four categories: normal blood pressure, elevated blood pressure, stage 1 hypertension, and stage 2 hypertension. A patient’s blood pressure will be referred to as normal when it’s below 120/80 mmHg. A patient will be referred to as having an elevated blood pressure when they post diastolic measurements of below 80 mmHg and systolic pressures ranging from 120 to 129 mmHg. Elevated blood pressure eventually gets worse if no steps are taken. A patient will be experiencing stage 1 hypertension when their systolic pressures range from 130 to 139 mmHg or diastolic pressures that will range from 80 to 89 mmHg. A patient with a systolic pressure of 140mmHg or higher or diastolic pressures of 90mmHg or higher is said to have stage 2 hypertension, which is more severe. Treatments The most effective treatments for hypertension include medications combined with lifestyle changes. The most common medications to treat hypertension include thiazide diuretics, angiotensin II receptor blockers (ARBs), Angiotensin-converting enzyme (ACE) inhibitors, Calcium channel blockers, Alpha-beta blockers, Beta-blockers, Alpha-blockers, Renin inhibitors, Aldosterone antagonists, Central-acting agents, and Vasodilators (Wenger et al., 2018). Lifestyle changes, including getting regular physical activity, eating a healthy diet with less salt, limiting alcohol intake, and maintaining a healthy weight are also central to controlling blood pressure (Wenger et al., 2018). References Chen, H.-Y., & Chauhan, S. P. (2019). Hypertension among women of reproductive age: Impact of 2017 American College of Cardiology/American Heart Association high blood pressure guideline. International Journal of Cardiology Hypertension, 1, 100007. doi:10.1016/j.ijchy.2019.100007. Kitt, J., Fox, R., Tucker, K. L., & McManus, R. J. (2019). New Approaches in Hypertension Management: a Review of Current and Developing Technologies and Their Potential Impact on Hypertension Care. Current hypertension reports, 21(6), 44. Wenger, N. K., Arnold, A., Bairey Merz, C. N., Cooper-DeHoff, R. M., Ferdinand, K. C., Fleg, J. L., Gulati, M., Isiadinso, I., Itchhaporia, D., Light-McGroary, K., Lindley, K. J., Mieres, J. H., Rosser, M. L., Saade, G. R., Walsh, M. N., & Pepine, C. J. (2018). Hypertension Across a Woman’s Life Cycle. Journal of the American College of Cardiology, 71(16), 1797–1813. Yao L, Ruifang C, Jingjing C, Zhijun H & Hong Y (2018). The management of hypertension in women planning for pregnancy, British Medical Bulletin, Volume 128, Issue 1, Pages 75–84, RESPONSE 1 Hypertension, either chronic or pregnancy-related, is a common complication of pregnancy. When severe, it can lead to stroke and death, but prompt recognition and treatment can reduce the risk of these complications. When hypertension is diagnosed in a pregnant woman, the major issues are establishing a diagnosis ,deciding the blood pressure at which treatment should be initiated and the target blood pressure, and avoiding drugs that may adversely affect the fetus (Brown et al., 2018). The American College of Cardiology and the American Heart Association have endorsed a lower cutoff point (systolic blood pressure 130 to 139 mmHg or diastolic blood pressure 80 to 89 mmHg) for diagnosing hypertension in nonpregnant individuals. They also removed massive proteinuria (5 g/24 hours) and fetal growth restriction (FGR) as possible features of severe disease because massive proteinuria has a poor correlation with outcome, and FGR is managed similarly whether preeclampsia is diagnosed. Oliguria was also removed as a characteristic of severe disease. The International Society for the Study of Hypertension in Pregnancy continues to include FGR as one of the criteria that can establish a diagnosis of preeclampsia in a woman with new-onset hypertension after 20 weeks of gestation since both preeclampsia and growth restriction are manifestations of a primary placental disorder . According to NHBPEP methyldopa, labetalol, beta blockers (other than atenolol), slow release nifedipine, and a diuretic in pre-existing hypertension are considered as appropriate treatment. If a woman’s blood pressure is well controlled on an agent pre-pregnancy, she may continue it during pregnancy, with the exception of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. If restarting drug therapy in women with chronic hypertension, methyldopa is recommended as first line therapy. For emergency treatment in preeclampsia, IV hydralazine, labetalol and oral nifedipine can be used. The ACOG also recommend that methyldopa and labetalol are appropriate first-line agents and beta-blockers, and angiotensin-converting enzyme inhibitors are not recommended (ACOG, 2020). References Brown MA, Magee LA, Kenny LC, et al. Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. Hypertension 2018; 72:24. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstetric Gynecology 2020; 135:1492. THIS IS THE INSTRUCTOR RESPONDING TO MY POST RESPONSE 2 does treatment differ in women vs men? if yes, how so? THIS 2 SEPARATE ASSIGNMENT 1 PAGE FOR EACH



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