The other day a few students got into a heated debate over risk factors for developing hypertension which was a question on our exam. here's the question with the choices. tell me who do you all think is more at risk. and it's very obvious which one is right.
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
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
I think this question was kinda stupid. all those choices are risk factors. my instructor or whoever wrote the exam should know that HTN increases with age as well as being overweight/obese. so if someone who is 65 yrs. old and 30 lbs. overweight already, most likely has HTN.
I think this question was kinda stupid. all those choices are risk factors. my instructor or whoever wrote the exam should know that HTN increases with age as well as being overweight/obese. so if someone who is 65 yrs. old and 30 lbs. overweight already, most likely has HTN.
That's not the point. Yes, all those options were risk factors - but the question is asking you to identify the person with the highest risk. I choose option C because he has a known family history of HTN whereas with the others it's a guessing game.
What answer was considered the best answer (and why) by the person who wrote the test?
The correct answer was choice A. i chose C. my instructor said evidence shows that AA has a higher risk for HTN than other racial groups, and that was that. there is no evidence that AA has some kind of genetic defect or defective gene like there is with breast cancer, hunington's disease, that i'm aware of that would make them a higher risk. alot of HTN that occurs with AA is because of high fat/sodium diet as well as being overweight. those are risk factors that can be controlled to reduce HTN.
That's not the point. Yes, all those options were risk factors - but the question is asking you to identify the person with the highest risk. I choose option C because he has a known family history of HTN whereas with the others it's a guessing game.
Look at it this way. Who has more chance of developing lung cancer?
a) 65yo who smokes
b) 30yo with family history of cancer.
Same premise as your question - B has positive FMH, but no other stated risk factors, while A is 65, and currently has a physiologic risk factor for lung ca (smoking). Family history as a risk factor does not necessarily trump other risk factors - you have to look at the "patient" in the question as a whole, based on the info given.
Yes ... A ...good. Sometimes the obvious answer is the correct one. Age, race, and a current known physical condition (weight) are definitely stronger predictors than is the fact that a person has 1 family member with HTN. If all it took was to have 1 family member, almost everyone would have HTN -- including the man in response A. Think about it ... when you think of everyone's parents, grandparents, great-grandparents, aunts, uncles, etc. There are few of us with a family tree completely free from HTN.
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.
So what did your instructor say is the right answer? :) I see what you're saying but I'm not sure if I agree. Remember, you're contradicting yourself a bit here. You're saying in one breath that genetics WILL make the 35 year old develop HTN (or be at high risk), but that being AA WON'T (a genetic/racial disposition to certain conditions is often found in AA people). I know many AA, Aboriginal, and East Indian people for example that have HTN and/or Type 2 diabetes, which is usually associated with being overweight and lifestyle. But these people are thin, eat healthy, and are active. It is well known that some (non-white) races have a higher genetic disposition to certain diseases. HTN is one of them.
Also, if the person who is 35 has a very strong history, her familial HTN may have nothing to do with lifestyle and there is no way for her to prevent it no matter what you do. While many are, not all cases of HTN are lifestyle related, as I mentioned earlier. Especially if she has a very strong family history and none had related risk factors. These are cases for the MD to solve and not for nurse teaching. In the case of the AA man, he has a total of 4 risk factors Vs. the woman's 1, and 1 of them can be modified by current nurse intervention. So I still think A is a better answer. :)
I know some people have assumed the the AA man already HAS HTN, which may or may not be correct. But I don't think an LPN instructor is trying to make a question more complicated then it has to be. If you aren't going to assume that being AA puts the man at a higher risk for HTN, then it's almost ironic (IMHO) to assume that he already HAS HTN for the purpose of this question.
All in all, I don't know who's right. For the purposes of nurse education, I used the numbers game (I'm a numbers person :)) If you were looking at this from a medical standpoint, sure, you'd want to know more about the genetic background of C, and if A LACKED any history of HTN in his family (genetic protection or lack of disposition). For example, while we all know that smoking damages DNA, not many people know that the people who tend to get lung cancer often have a gene variant than makes them predisposed to it. Hence why some people will live to 90 and smoke like a chimney. They don't have the gene variant. But this is all not something that your typical nurse would need to know. Your job is patient education for the majority of people who have lifestyle related and modifiable risks, and general assumptions are made about those risks. When you look at this generally, I can see how some pick either A or C.
I'm really curious to know though. Will you please tell us who in the end is right? Did you get the question right and everyone else picked A and got it wrong. I'm willing to admit that I'm wrong, but I want to know more.
Without reading any of the posts. I would choose A. I would choose A because he is AFRICAN AMERICAN and Male which are are two non-modifiable risk factors. On top of that, he's overweight. Just my two-cents. ( Now I'm going to scroll up, to see what the answer was)
From my understanding African-American women, not men, are at highest risk for developing HTN.
that maybe, but the Mayo clinic information doesn't specify it as either or...it says
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.
So even if this had been a 65 year old AA woman who is 30 LB overweight, I would have said the same thing...because playing a numbers game, this person is more at risk than any of the others to become hypertensive.
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dblpn
385 Posts
I think this question was kinda stupid. all those choices are risk factors. my instructor or whoever wrote the exam should know that HTN increases with age as well as being overweight/obese. so if someone who is 65 yrs. old and 30 lbs. overweight already, most likely has HTN.