According to Statistics SA hypertension is one of the leading non communicable diseases in South Africa1. It is a major risk factor for the development of various cardiovascular diseases and thus has been shown to contribute to heart failure and stroke. There is a high prevalence of undiagnosed and untreated hypertension in South Africa1. In order to improve therapeutic interventions it is essential to understand all the mechanisms that are associated with this disorder. Therefore recent studies have shown that 24hr blood pressure profiles could assist with improving our understanding of hypertension2.
Blood pressure profiles indicate that blood pressure varies diurnally throughout 24 hours, being higher during the day and lower during the night3. Normal blood pressure variation is considered to be 10-20-% less at night compared to daytime4. Therefore people with a nocturnal blood pressure decrease of 10-20% are classified as dippers, and those who have a nocturnal BP decrease less than 10% are classified as non-dippers4. It makes sense for blood pressure to be higher during the day as individuals are more active therefore have increased sympathetic nervous system (SNS) activity. During the night however, the body is in a state of rest therefore there is less SNS activity as the parasympathetic nervous system (PNS) takes over5.
Non-dipping is 25-35% more prevalent in hypertensive patients compared to normotensive patients6. As a result hypertensive patients are more prone to cardiovascular events such as myocardial infarction, congestive heart failure, unstable angina and transient cerebral ischemia6. Greater incidences of these cardiovascular events have been reported especially in female hypertensive patients6.
The cause of...
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...s evidence that confirms that natriuresis decreases sodium retention thus increasing the synthesis of nitric oxide. Nitric oxide is a vasodilator and therefore increased concentration would further promote arteriolar vasodilation13.
Dietary Approaches to Stop Hypertension (DASH diet) have recommended increasing dietary potassium intake through consumption of fruits and vegetables which are high in potssium14. There several other proposed beneficial effects of K+ such as decreased sensitivity to norepinephrine and angiotensin II, and baroreceptor sensitivity15.
The positive effects of dietary potassium on lowering blood pressure are well documented but whether these benefits extend to nocturnal blood pressure dipping has not been established yet. Therefore the aim of this study is to investigate the beneficial effects of potassium on nocturnal blood pressure dipping.
How does this history of high blood pressure demonstrate the problem description and etiology components of the P.E.R.I.E. process? What different types of studies were used to establish etiology or contributory cause?
Renin angiotensin system activation: Because of decreased blood flow to the kidneys the compensatory mechanisms activate to hold on to sodium and water. When the Blood flow is decreased Angiotensin II is released causing vasoconstriction
The Mayo Clinic’s book on High Blood Pressure was full of detailed facts about blood pressure and what it is. This is extremely significant to the experiment because blood pressure is one of the variables being tested. Understanding blood pressure is one of the key components to receiving accurate results from this experiment. Most of the book is on high blood pressure, which is not necessary for the experiment, but the book still had plenty of useful information about blood pressure itself. The book explains that when the heart beats, a surge of blood is released from the left ventricle. It also tells of how arteries are blood vessels that move nutrients and oxygenated blood from the heart to the body’s tissues. The aorta, or the largest artery in the heart, is connected to the left ventricle and is the main place for blood to leave the heart as the aorta branches off into many different smaller
Together extra-renal factors (insulin, epinephrine, aldosterone) and renal factors maintain a normal potassium plasma concentration in the body. The extra-renal mechanisms are responsible for moving potassium into the intracellular compartment. The renal mechanisms are responsible for chronic maintenance of body potassium content. When these mechanisms are functioning correctly, large intake of potassium has a minor and insignificant effect on the potassium concentration in the plasma. [5&6]
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Some people may experience: bad headache, mild dizziness, and blurry vision. Traditionally, diagnosis of high blood pressure (BP) has relied on consecutive checks of clinic BP over a 2 to 3 month period, with hypertension confirmed if BP remains persistently raised over 140/90 mmHg. This method of diagnosis has significant limitations because the BP measured for an individual patient in a clinic setting may not reflect their BP in day-to-day life. The main concern is that as a result of the “white coat syndrome”, hypertension may be over-diagnosed when checked in the clinic setting; resulting ...
The causes of hypertension are unknown. However; hypertension can be classified into two categories primary and secondary. Primary (essential) hypertension is increas...
" Journal of Clinical Hypertension 13.5 (2011): 351-56. EBSOHost.com - a. Web. The Web.
The plan and aim of this project is to select a group of six people and record their blood pressure, temperature, pulse and respiration whilst at rest. When they return from a brisk walk I will then record the same observations and analyse, evaluate the results. With this information I will then draw my conclusions and make recommendations.
The research purpose is derived from the research problem. The purpose of this study which was clearly outlined in the introduction section of the paper, sought to determine if automatic blood pressure devices could measure orthostatic hypotension accurately in emergency settings. This purpose was accompanied by research objectives and a hypothesis that focused the study. The objectives in the study sought to find the sensitivity, specificity, positive predictive value and negative predictive value of the automatic devices, clinical and statistical significance in postural drops, and if magnitude influenced blood pressures readings (Dind et al., 2011, p. 527).The authors also predicted in their hypothesis that the automatic devices would be less accurate if the systolic blood pressures were not between 120-180 mmHg which is their...
Hypertension is a developing problem worldwide，associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%, compared to white males at 31.5% of the population. The hypertension rate of black females was more than twice that of white females. The death rate from hypertension among black males was 51.8 per 100,000, and among black females was 40.4 per 100,000; however, the morta...
In some studies, CAM approaches have shown potential for controlling hypertension, but more research needs to be done to show the safety and effectiveness. Some herbs and supplements show evidence of lowering blood pressure. Omega-3 fatty acids are found in fish, some nuts and vegetables, and supplements. Research shows that they can decrease triglycerides (the major form of fat stored in the body), slow the buildup of fatty deposits inside arteries, decrease the risk of abnormal heartbeats, and lower blood pressure slightly (Hirsch). Coenzyme-Q10 is produced by the body and is also available in supplements, there is good scientific evidence that coenzyme Q-10 does lower blood pressure (Hirsch). Furthermore, Garlic contains sulfur that has a positive effect on cholesterol levels, which could lower blood pressure levels. Cocoa products and dark chocolate are rich in antioxidants. A study shows that when people with high blood pressure consumed cocoa twice daily for two weeks, it improved the ability of artery walls to relax but did not lower blood pressure significantly (Hirsch). A patient who is taking alternative medicines needs to let their physician know because some herbs and supplements will interact with other medication. Relaxation techniques help relax the body and reduce stress, which could help with blood pressure.
Sodium is vital for biochemical processes in the body. One of its many functions is to maintain osmotic pressure of extracellular fluid to regulate water excretion and retention. It aids in the regulation and the transmission of nerve impulses in the nervous system by generating a voltage for action potentials which stimulate effector organs such as cardiac muscle, to contract. It also uses baroreceptors to sense changes in blood pressure and is a primary player in the Na+/K+ ATPase cellular
A study by St. George's Medical School in London found that taking potassium supplements lowers blood pressure. The study tested adults who had an average blood pressure of 151/93. After taking potassium supplements, participants were able to reduce their blood pressure to an average of
... that sodium ingestion (especially high contents) passes through extracellular compartments including the vascular system before getting eliminated by the kidneys. An acute increase of plasma sodium concentration can alter the mechanical properties of vascular endothelium, as long as aldosterone is present. Aldosterone not only plays a major role in adjusting sodium and potassium transport in kidneys but also on the cardiovascular system. Sodium accumulates in extracellular space when the kidneys cannot adequately adjust salt excretion to salt uptake and/or when the concentration of aldosterone is raised, leading to an increase in plasma sodium concentration. An important finding in these studies was the observed effects of amiloride, which acted to block sodium channels and prevented an increase in stiffness by reversing the increasing in cell volume and pressure.
Schnall, P., Landsbergis, P., Belkic, K., Warren, K., Schwartz, J., & Pickering, T. (1998). Findings In The Cornell University Ambulatory Blood Pressure Worksite Study: A Review. Psychosomatic Medicine, 60, 697.