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Chronic Disease: Hypertension

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kei tung chan

on 17 November 2014

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Transcript of Chronic Disease: Hypertension

Management 1 - Medication
Current Trend

Sign and Symptoms of hypertension

“silent killer”

Only when blood pressure readings soar to
dangerously high levels
may obvious symptoms occur :

Blood Pressure
systolic pressure/diastolic pressure
(e.g. 120/80mm Hg)

-Systolic pressure:
blood pressure
(normally 100-140 mm Hg)

-Diastolic pressure:
the blood pressure when the heart in
(normally 60 to 90mm Hg)

Diagnosis of hypertension

-High blood pressure

Persistent elevation
of the:
1)systolic bp:
140mmHg or higher
, and

2)Diastolic bp:
90mm Hg or higher
-Carry out
blood pressure
test by using blood pressure monitor (sphygmomanometer).

For people over
age 60
, high blood pressure is defined as
150/90 or greater

1 Introduction of Web Page
2 Definition & Cause of Hypertension
3 Prevalence of Hypertension of Elderly in HK
4 Risk Factor of Hypertension for Elderly
5 Signs & Symptoms of Hypertension
7 Prevention and Management
8 Complication
9 Related Community Based Resources
10 Evaluation of Learning Outcomes and Web Page Content

Better HEART Better LIFE:
Understand the Hypertension

Toolkit on prevention of hypertension
12115178D Chan Pui In
12112003D Chan Kei Tung
12113122D Sze Sha Sha
12115125D Wong Hung Yim
12115261D WU CHUI SHAN
12113267D Lau Kee Ming

Introduction of Web Page
1 To provide the
information about hypertension
to the elderly and their caregivers.

2 To raise the their
on the hypertension.

3 To provide the

of hypertension for them.

4 To provide the detailed
community resources
information for them.

(Black & Hawks, 2009)
(Black & Hawks, 2009)
1 Research:
-Thematic Household Survey Report No. 50: Health status of Hong Kong residents

2 Number of Participants:
-1,896,100 (all age group)

(Census and Statistics Department [CSD], 2013)

Current Trend
Prevention and Medication Management of hypertension

Tip 1: Lifestyle Changes

Tip 1: Lifestyle Changes

Tip 1: Lifestyle Changes

Tip 1: Lifestyle Changes

Tip 1: Lifestyle Changes

Tip 2: Stress coping strategies
Golden Rule:Avoid family conflicts and breathe deeply when encountering stress.

Non-Modifiable Risk Factor

Modifiable Risk Factor


Complication (cont’d)

Related Community Based Resources

Blood Pressure Monitoring
Evaluation of Learning Outcomes and Web Page Content


(Taylor, R. S. et.al, 2011)

(Captured from the America Centers for Disease Control and Prevention, 2011)

The second goal is to encourage the elderly to consume more anti-hypertensive food.

We provided a list of food choices and DASH diet for the elderly to choose and a list to be avoided.

(Huang et. al., 2013.)

This DASH (DietaryApproaches to Stop Hypertension) Diet guideline is provided for caregiver download to follow.

(capture from dashdiet.org)

Light and moderate exercise pattern should be introduced in order to have better BP control
Obesity is one of the risk factor for hypertension.
‘Caregiver or Doctor should assess the limit of the client and provide suitable training suggestions.’

Due to the lower degree of movement in elderly,we suggest three types of light exercise for elderly.

(American Elder Gym, 2010)

1. Heredity
→ The prevalence of hypertension is increasing among the family who has members diagnosed of high blood pressure

2. Age

High blood pressure usually affects elderly aged over 60. The elasticity of the blood vessels walls are gradually deteriorating along aging

(Suzuki& Saruta, 2004)

• Retinopathy (Eye damage)
Hypertension can cause small blood vessels in the eye to burst or
bleed. This can lead to
blurred vision
or even

• Peripheral vascular disease (PVD):
Hypertension can narrow and harden the arteries that leads to
blood flow
to the
legs, arms, stomach

• Impotence or erectile dysfunction:
Changes in the blood vessels that may prevent
blood from filling the penis or from remaining
there long enough to maintain an erection.

(British Columbia Medical Association,2008)
(Ng, Stanley & Williams, 2010)

(1) Community Nursing Services (CNS)
- continuous nursing care for patients who are discharged from hospital through home visits by qualified nurse
Tuen Mun CNS Main Centre
Tel : 3511 1189
Address: 5/F, Tuen Mun Eye Centre, 4, Tuen Lee Street, Tuen Mun, NT

(2) Community Rehabilitation Network (CRN)
- multi-disciplinary team provides physical, social and psychological support for patients and their care-givers
Tai Hing Centre
Tel: 2775 4414
Address: No.26-33, G/F, Hing Cheung House, Tai Hing Estate, Tuen Mun, NT
(1) Video of self-help digital blood pressure monitor:

(2) Blood Pressure Range Chart:

(3) Price of digital blood pressure monitor ~$450 - $1500
Purchase at pharmacy or medical equipment store
Thank you for visiting this hypertension web page. We hope that we can collect your valuable advice to improve the content of this page through the following questionnaires.

You are: Elderly/ Caregiver/ The Public/ Health Profession

My views on this page:
(Strongly agree / agree / disagree / strongly disagree)

1. The information of this web is detailed.
2. The web content is clear and easy to understand.
3. The web content could meet your needs.
4. The web increased my awareness of hypertension.

American Heart Association (2014). What are the symptoms of high blood pressure? Retrived from 6 Novemeber, 2014

Berman, A. & Snyder, S. (2014). Kozier & Erb's Fundamental of Nursing Concepts, Process and Practice. Edinburgh: Pearson Education Limited.

Black, J. M., Hawks, J. H. (2009). Medical-surgical nursing: clinical management for positive outcomes (8th ed.). USA: Elsevier Saunders.

Blumenthal, J. A., Babyak, M. A., Hinderliter, A., Watkins, L. L., Craighead, L., Lin, P. H., ... & Sherwood, A. (2010). Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Archives of internal medicine, 170(2), 126-135.

British Columbia Medical Association. (2008). Hypertension – Detection, Diagnosis and Management. Guideline and protocols.

Census and Statistics Department. (2013). Thematic Household Survey Report No. 50. Retrieved from: http://www.statistics.gov.hk/pub/B11302502013XXXXB0100.pdf

Constance, C. (2009). The Good and the Bad: What Researchers Have Learned About Dietary Cholesterol, Lipid Management and Cardiovascular Disease Risk Since the Harvard Egg Study. International Journals of Clinical Practice, 68(163)

Hong Kong Society for Rehabilitation. (2010). Community Rehabilitation Network. Retrieved from http://www.rehabsociety.org.hk/e/getContent1eea.html.

Hosiptal Authority. (n.d.). Community Nursing Services. Retrieved from http://www.ha.org.hk/haho/ho/adm/102115e.htm

Huang, W. Y., Davidge, S. T., & Wu, J. (2013). Bioactive Natural Constituents from Food Sources—Potential Use in Hypertension Prevention and Treatment. Critical reviews in food science and nutrition, 53(6), 615-63.
Jia, B., Wang, X., Kang, A., Wang, X., Wen, Z., Yao, W., & Xie, L. (2012). The effects of long term aerobic exercise on the hemorheology in rats fed with high-fat diet.Clinical Hemorheology & Microcirculation, 51(4).

Kulkarni, S., O'Farrell, I., Erasi, M., & Kochar, M. S. (1998). Stress and hypertension. WMJ: official publication of the State Medical Society of Wisconsin, 97(11), 34-38.

Lemogoum, D. (2014). Challenge for Hypertension Prevention and Control Worldwide: The Time for Action. The Journal of Clinical Hypertension, 16(8), 554-556.

Martins D, Norris K, Podymow T, August P (2009). Chapter 43. Hypertension in High-Risk Populations. In Lerma E.V., Berns J.S., Nissenson A.R. (Eds),CURRENT Diagnosis & Treatment: Nephrology & Hypertension.

Ng, K. H., Stanley, A. G., & Williams, B. (2010). Pathogenesis, risk factors and prevention of Hypertension. Medicine, 38(8), 403-408.

Racine, E., Troyer, J. L., Warren-Findlow, J., & McAuley, W. J. (2011). The effect of medical nutrition therapy on changes in dietary knowledge and DASH diet adherence in older adults with cardiovascular disease. The journal of nutrition, health & aging, 15(10), 868-876.

Svetkey, L. P., Simons-Morton, D., Vollmer, W. M., Appel, L. J., Conlin, P. R., Ryan, D. H., ... & Kennedy, B. M. (1999). Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Archives of internal medicine, 159(3), 285-293.

Suzuki, H., & Saruta, T. (2004). Kidney and Blood Pressure Regulation. Basel: Karger.

Taylor, R. S., Ashton, K. E., Moxham, T., Hooper, L., & Ebrahim, S. (2011). Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials (Cochrane review). American journal of hypertension, 24(8), 843-853.

Vokonas, P. S., Kannel, W. B., & Cupples, L. A. (1988). Epidemiology and risk of hypertension in the elderly: the Framingham Study. Journal of hypertension. Supplement: official journal of the International Society of Hypertension, 6(1), S3-9.

(Berman& Snyder, 2014)
(Constance, 2009)
(Jia, Wang, Kang, Wang, et al., 2012)
(Hosiptal Authority, n.d.)
(Hong Kong Society for Rehabilitation, 2010)
Q & A
1 Name of the Web Page:
Better HEART Better LIFE:
Understand the Hypertension

2 Target Group:
-Elderly and their Caregivers

3 Aim:
-To provide some
clear information
who can understand more about the Hypertension and the self-care skills Easily.
-There are also some
detailed information
attached in this platform for the
to care their family with hypertension Conveniently.

Early Report to your doctor for any abnormal findings
Who will be the
Salts contains sodium which cause hypertension.
We suggest them to take only the adequate which is approximately 1 teaspoons (2300 mg) and avoid intake of
all salty food

According to Lemogoum in a report called' Challenge for Hypertension Prevention and Control Worldwide: The Time for Action.' in 2014 stated that the current increasing burden of hypertension is largely attributable to behavioral factors such as:

A. Unhealthy Diet (excessive salt ,low fruit and vegetable consumption)
B. Physical inactivity and obesity
C. Other harmful habits (smoking, alcohol consumption..etc)

4 ground rules to follow
Rule 1: Avoid the harmful food we introduce
Rule 2: Consume the anti-hypertensive food we introduce
Rule 3: Adopt healthy pattern of light exercise
Rule 4: Quit smoking and drinking alcohol,coffee
**Stress Coping is so important to prevent emergency incidents to happen.
2. Stretching Exercise
1. Balancing Exercise
3. Postural Exercise
1. Balancing Exercises Steps to follow
Type 1
Type 2
2. Stretching Exercise Sequence
3. Postural Exercise
1st way to relieve stress: Tai Chi
→ High cholesterol level may narrow the lumen of blood vessels
→ Excessive sodium retention or sodium intake by kidney leads to blood pressure elevation
→ High intake of fatty food
Inadequate Exercise
→ Fats excessively accumulate in blood vessels
→ ↓ contractivity of muscle of blood vessels
→ Nicotine in cigarette causes vasocontriction

→ ↑hormones to increase the blood pressure and heart rate
(Berman& Snyder, 2014)
(Berman& Snyder, 2014)
(Berman& Snyder, 2014)
Tai Chi 10 forms demonstration video
2nd way: Deep Breathing Exercise
3 simple ways preventing hypertension

A. Lifestyles Changes
B. Stress Coping Strategies
C. Self-monitor blood pressure

How to quit smoking and drinking alcohol effectively?
The most important rule is to find
someone to stay together fighting
all the temptation of drinking and smoking!
Go> http://www.myreclaimedlife.com/ to find your company and share your story!
Useful Resources To Seek Help
Family Members
Social Workers
Community Resources
like 'COSH'

Heart disease
-Ischaemic heart disease
-Left ventricular hypertrophy
-Heart failure

A weakened blood vessel may rupture and bleed into the brain.
A blood clot blocking a narrowed artery causes a stroke.

• Chronic kidney disease (CKD):
Kidney failure requiring dialysis or transplant.
(British Columbia Medical Association,2008)
(Ng, Stanley & Williams, 2010)

(Census and Statistics Department [CSD], 2013)

(Martins, Norris, Podymow & August, 2009)
(American Heart Association, 2014)

- Quit smoking

- Reduce alcohol and coffee consumption

- Control body weight

- Pay attention to diet
the consumption of
salty foods & salt restriction
(2 -3 g per day = A half of the teaspoon )

- Regular aerobic exercise
water sports,

Tai Chi

Captured from ElderGym.com
Captured on http://www.exerciseforlife.com.au/
To Caregivers
To Caregivers
To Caregivers
To Caregivers
To Caregivers
Management 2 -
Maintain good living habits

Medication Management
1. Take out your Antihypertensive Drug
2. Search the drug and
Find out the information in this chart

To Caregivers
To Caregivers
Thank You
If you have any problems about Hypertension or any advices on this website, please contact us:
Do not Hesitate, Share this Web Page with your Friends!
To Caregivers
Full transcript