High blood pressure

TerryBSN · Aug 12, 2009

Someone had ask for my source of information, I have two resources which are required text for my graduate classes.

Primary Care A Collaborative Practice, 3rd edition by Buttaro, Trybulski, Bailey & Sandberg-Cook.

Pg 572 and 573 define the JNC 6 and JNC 7 as having established new blood pressure parameters which now include a category of prehypertension which is Systolic of 120 and Diastolic at 80-89.

Clinical Guidelines in Family Practice, 4th edition by Uphold & Graham.

Pg 486 states the same and reports that the JNC 7 have established new blood pressure parameters.

Also pg 485 states "treatment goal is lowered to 130/85 (or 125/75 in patients with renal disease and severe proteinuria)".

I have HTN and was diagnosed at 22 and have been on medication since then and about 3 years ago was placed on a second medication, which my MD changed 2 weeks ago and he stated that the guidelines had changed a little over 1 1/2 years ago and he wants my BP below 120/80.

BBFRN, BSN, PhD · Sep 4, 2009

Here is the statement from the AHA regarding the new guidelines, resulting from JNC 7:

http://www.americanheart.org/presenter.jhtml?identifier=3025147

Bobylon · Sep 4, 2009

Just took care of a guy who, the day after a massive MI that almost killed him, went outside to smoke. Refused the patch, refused Chantix, refused Ativan, refused everything.

Hah .... have had a few pts like that as well ..... admitted to Cardiac Rehab unit, going out to smoke, even smokin in their rooms (and they deny it like we can't smell it .... knuckleheads, I tell ya !!!). You can do your best to help people, but you can't save them from themselves, unfortunately....

Rook · Sep 5, 2009

I know this lady whose had bp like 140-150/ 90 something for like almost 10 yrs w/o any blood pressure meds. She's somewhat obese. I keep trying to tell her to go to the doctor but she has no health insurance. Am I correct in telling her she's heading for heart attack or stroke? Which one? She says she feels fine. Can ppl normally feel fine before they have heart attacks and strokes?

There are free clinics, other places where you could see a RN practionshier for say $40-50 as well. Also remember that many BP meds are dirt cheap you could get a months supply of good meds like atenolol, metoporol, or Imdur et.al for under $10.

talaxandra · Sep 5, 2009

Although >140/90 is considered hypertension, some health organisations have proposed the idea of pre-hypertension for people who consistently have a BP >120/80 but under the hypertension level. In addition to lifestyle change like weight loss, reducing fat and salt intake, quitting smoking, regular exercise etc, it's been suggested that some of these people may benefit from prophylactic antihypertensives.

For people with diabetes, maintaining a BP

None of which helps the OP. As others have said, which an elevated BP increases the risk of heart attack, stroke and organ failure, it doesn't mean those consequences are inevitable. If your friend thinks seeing a doctor (+/- medication) is to expensive, can you suggest incremental lifestyle modification? It's less expensive, has better long term results than drugs alone, and may be les confronting than "your BP's too high and your brain could explode" (not that I'm saying that's what you're saying!)

classykaren · Sep 5, 2009

Try to find her a free clinic since she has no money

Katie82, RN · Sep 5, 2009

Heart attack and stroke may be the least of her risks, she is probably also walking around with kidney damage and diabetes.....

eclecticlife · Sep 5, 2009

Perhaps the original post was designed to stimulate discussion? Its all well and goo to state 'they should know it' or that 'google works' but if we all did know or googled everything then this board would be a lot less interesting!

As a student I will also tell you that I know what I was told during lecture and I know what I have seen but its always valuable to hear other perspectives and real 'case histories' as it were.