Who's most at risk for developing HTN?

nlion87 · Jul 17, 2009

choice a

risk factors

by mayo clinic staff

high blood pressure has many risk factors. some you can't control. high blood pressure risk factors include:

age. the risk of high blood pressure increases as you age. through early middle age, high blood pressure is more common in men. women are more likely to develop high blood pressure after menopause.
race. high blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. serious complications, such as stroke and heart attack, also are more common in blacks.
family history. high blood pressure tends to run in families.

other risk factors for high blood pressure are within your control.

being overweight or obese. the more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. as the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
not being physically active. people who are inactive tend to have higher heart rates. the higher your heart rate, the harder your heart must work with each contraction-and the stronger the force on your arteries. lack of physical activity also increases the risk of being overweight.
using tobacco. not only does smoking tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. this can cause your arteries to narrow, increasing your blood pressure.
too much salt (sodium) in your diet. too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
too little potassium in your diet. potassium helps balance the amount of sodium in your cells. if you don't consume or retain enough potassium, you may accumulate too much sodium in your blood.
too little vitamin d in your diet. it's uncertain if having too little vitamin d in your diet can lead to high blood pressure. researchers think vitamin d may affect an enzyme produced by your kidneys that affects your blood pressure. more studies are necessary to determine vitamin d's role in blood pressure.
drinking too much alcohol. over time, heavy drinking can damage your heart. having more than two or three drinks in a sitting can also temporarily raise your blood pressure, as it may cause your body to release hormones that increase your blood flow and heart rate.
stress. high levels of stress can lead to a temporary, but dramatic, increase in blood pressure. if you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
certain chronic conditions. certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea.

sometimes pregnancy contributes to high blood pressure, as well.

although high blood pressure is most common in adults, children may be at risk, too. for some children, high blood pressure is caused by problems with the kidneys or heart. but for a growing number of kids, poor lifestyle habits-such as an unhealthy diet and lack of exercise-contribute to high blood pressure.

nlion87 · Jul 17, 2009

take it back C. Buy 65 and fact he is overweight he already probably has HTN With C given family histoiry, potential for developement is likely. I read question wrong

ShannonRN2010, BSN, RN · Jul 17, 2009

My gut says A, because he's older and is African American...plus he's 30 lbs overweight.

bear19kilosgirl2 · Jul 17, 2009

I would say A as well.

allnurses Guide · Jul 17, 2009

Definitely A. The risk for African American males of that age, esp being overweight...

Daytonite, BSN, RN · Jul 18, 2009

who's at most risk for developing hypertension?

a. a 65 yr. old 30 lb. overweight african american male.

b. a 50 yr. old woman who smokes

c. a

35 yr. old

woman with a

family history of hypertension

d. a 65 yr. old white male thats 5 lb. overweight

a risk factor is a chemical, psychological, physiological or genetic element that may predispose someone to a disease. there are risk factors that are controllable and uncontrollable. "a" would have already had htn since african american males tend to develop htn early if they are going to get it. "b" also would have had evidence of a rising bp since smoking is a habit which they would have been doing over a number of years causing gradual damage to the vessels during that time which would be manifested by a gradual increase in the bp. while bp does elevate over time with age, 5 pounds of extra weight isn't going to push "d" into a htn situation.

http://www.nhlbi.nih.gov/health/dci/diseases/hbp/hbp_whoisatrisk.html

EricJRN, MSN, RN · Jul 18, 2009

I'd definitely go A. Age is the number one risk factor for HTN, African Americans have much higher rates of HTN and the weight issues further increase the risk. While African American patients do tend to develop HTN earlier, there is a huge disparity in access to care, so it's common to see patients diagnosed at an advanced age (and often only after significant end organ damage has taken place).

CanuckStudent · Jul 18, 2009

A.)

These types of questions are terrible, but there is usually one clear(er) answer. In this case, it's a numbers game. A male African American, older age, and overweight. Here are 4 reasons that will increase the risk of HTN. 4 risk factors tops the rest. Male AAs are very high risk. This may be due to a genetic susceptibility to be sodium sensitive or to HTN itself, proneness to obesity, or other lifestyle factors common in this group, such as diet or smoking. AAs also tend to have a higher rate of Type 2 diabetes and its complications, another risk factor. They also tend to respond to anti-hypertensive drugs differently, which can make treatment more of a challenge.

While the 35 year old likely has a strong genetic risk for example, that is only 1 factor, unless she has other risk factors or a co-morbid condition such as kidney disease for example.

Some cases of HTN are secondary to other diseases or disorders (Cushing's, Hyperthyroidism, blood vessel disorders and defects) and can occur in young, thin, fit, active, etc. people, but generally speaking, many cases are linked to ageing (primarily isolated systolic), excess weight, and lifestyle factors.

In theory, all of these people are at a higher risk, but using numbers, A is the MOST likely solely based on the stats given. The idea for this is to be able to recognize when a patient has multiple risk factors, and which factors can be modified.

dblpn · Jul 18, 2009

HA HA...thank you daytonite! i said it was the 35 yr. old woman with family history of HTN. a 35 yr. old? what most people are missing here is the word risk. risk= "chances of" and the 65 AA male most likely already has HTN. if there is a family history it's a pretty sure bet that other family members are gonna get the disease. the 35 yr. old woman already has a genetic predisposition, maybe to getting HTN. so knowing that she is of greater risk she could take measures to reduce her chances of getting HTN.

Being an AA doesn't mean your gonna get high blood pressure just because you're AA. it's a persons diet and being overweight that makes AA at risk for being HTN. and that pretty much goes for any race. i think they should really clarify this because many people are assuming that just because you are AA you're gonna be HTN and that is not the case. which is why half the darn class picked choice A.

allnurses Guide · Jul 18, 2009

Do you already know the answer?

I don't agree with your reasoning that "A probably already has HTN" - that was not stated in the question. You cannot assume facts not in evidence in these questions - NCLEX books always say not to add info that isn't there.

- 35yo with FMHx of HTN, and no other stated risk factors or lifestyle factors that would contribute? or

- 65yo with predisposition due to race, age and weight (and probably diet, given his weight).

I'd still pick A.

Being an AA doesn't mean your gonna get high blood pressure just because you're AA. it's a persons diet and being overweight that makes AA at risk for being HTN. and that pretty much goes for any race. i think they should really clarify this because many people are assuming that just because you are AA you're gonna be HTN and that is not the case. which is why half the darn class picked choice A.

I don't think anyone picked a "just because" of his race - it's the age and weight as well. He has current physiologic risk factors, while the 35yo has family history but no stated issues such as weight, diet, etc.

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These type of questions are why nursing school sucks sometimes - you could argue for either of those answers (just take this thread as an example!). Let us know how it turns out.

bear19kilosgirl2 · Jul 18, 2009

Do you already know the answer?
I don't agree with your reasoning that "A probably already has HTN" - that was not stated in the question. You cannot assume facts not in evidence in these questions - NCLEX books always say not to add info that isn't there.
- 35yo with FMHx of HTN, and no other stated risk factors or lifestyle factors that would contribute? or
- 65yo with predisposition due to race, age and weight (and probably diet, given his weight).
I'd still pick A.
I don't think anyone picked a "just because" of his race - it's the age and weight as well. He has current physiologic risk factors, while the 35yo has family history but no stated issues such as weight, diet, etc.
================
These type of questions are why nursing school sucks sometimes - you could argue for either of those answers (just take this thread as an example!). Let us know how it turns out.

Exactly why I picked "A" as well.