Introduction
High blood pressure, known as hypertension, is a serious condition that can give rise to other heart diseases, including stroke. It is also known as a “silent killer” in the medical field, as it remains one of the leading causes of death worldwide. Beyond heart-related illnesses, high blood pressure can be a factor in kidney and other organ malfunction, affecting the whole body’s processes. Therefore, controlling high blood pressure (CBP) is crucial to prevent heart illnesses and other serious conditions. There are numerous ways to do that, including dietary changes, physical exercise, and hypertension medication. Combining these interventions and patient adherence to the treatment with the help of Nurse Practitioners (NPs) can lower high blood pressure and improve overall health. This effect, in turn, will mitigate the risks of developing more serious illnesses and conditions. This essay will focus on the interventions mentioned above, analyzing their healthcare costs and outcomes and using the Healthcare Effectiveness Data and Information Set (HEDIS) measure to rate them. According to this HEDIS measures of normal blood pressure standards at the end of the treatment period, all patient interventions analyzed are useful in CBP.
High Blood Pressure Medication
Prescribing medication for high blood pressure (BP medication) is one of the most traditional ways of patient intervention in primary care. This medication can be divided into four basic categories based on its action pathways: diuretics, beta-blockers, ACE inhibitors, and Angiotensin II receptor blockers. All of these types of prescriptions target different processes in the patient’s body but lead to the same result of lowering blood pressure (Cohen et al., 2022). There are more types of medication beyond these that are most commonly used. Most of the time, these drugs are used in combinations to achieve better results by targeting different causes of high blood pressure (Fuchs & Whelton, 2020). These factors can include certain hormones and chemical production, increasing the circumference of blood vessels, and other effects. According to Egan et al. (2018), using BP medication, patients can experience a sustained improvement in health outcomes and lowered blood pressure in 6-12 months. Moreover, for NPs, the medication is quite easy to manage regarding workload and consequent benefits, with only the need to familiarize the patient with instructions and dosage.
Dietary Approach to Hypertension
Dietary change is a more complicated form of patient intervention. In this case, NPs must ensure patients understand certain foods’ complex nutritional profiles and regimes. However, this approach, combined with other interventions, can produce the most sustainable decrease in blood pressure. Dietary Approach to Stop Hypertension (DASH) is the most commonly used dietary regimen (Fu et al., 2020). Moreover, this program is best suited for patients with high blood pressure caused by excessive weight and obesity, as this additional weight strains the heart system. This diet can be divided into three types: low-calorie, low-sodium and high-potassium, and salt restriction. Depending on the patient’s needs, one variety or combination of types is prescribed. Moreover, the NPs must monitor the patient’s weight and health changes to recommend the alteration of the diet if needed to guarantee that it meets sufficient nutritional needs. The main focus of this diet is to reduce the risk factors of high blood pressure in patients, including high concentrations of sodium and salt in blood and excessive weight. After mitigating these risk factors, this method of CBP is considered successful.
Physical Exercise Regimen
The physical exercise regimen is often used alongside the DASH diet. This regimen usually consists of aerobic exercise, resistance and isometric training, breathing control, meditation, and yoga (Fu et al., 2020). These exercises teach patients to control their blood pressure levels through proper breathing techniques. Moreover, they prepare patients for stressful and physically demanding everyday tasks, ensuring their blood pressure levels remain steady. Physical activity can guarantee muscle tonus for patients with excessive weight as they lose weight through the DASH diet. In this case, NPs’ duty is straightforward: to refer the patients to the exercise program. Overall, this method allows patients to establish healthy routines that strengthen their health and prevent serious illnesses.
Health Outcomes and Health Care Costs
As all the patient interventions have undeniable positive health outcomes mentioned above, their healthcare costs are also minimal. Only BP medication has the potential to put a monetary strain on health care, with possible increases in prices for these drugs. However, to ensure positive patient results and slowly eliminate the need for these drugs, NPs must refer patients to dietary and exercise programs. Without a change in diet and physical activity, many patients’ causes for high blood pressure remain unaddressed, including excessive weight, excessive salt consumption, and other factors. With this change, NPs will guarantee a reduced burden on the healthcare system as the patient’s health improves and they become unlikely to develop serious conditions (Hinton et al., 2020). In other words, talking to the patient about dietary changes and exercise is easier than treating them for stroke several years later.
Measuring Patient Ratings
NPs can measure the patient ratings similarly to the researchers who assess the efficacy of each patient intervention method. In their studies, scholars select a sample of a population with high blood pressure and usually a control group, applying the treatment to them. They generally measure the results by recording their blood pressure over a period of time, from months to years. This approach allows them to monitor the long-term effects of the treatment and eliminate other placebo-like effects that can occur a few weeks after the start of the experiment. One example is a study by Fu et al. (2020), which concluded that the DASH diet is the most efficient in lowering high blood pressure, with physical exercise only further boosting its results. Fu et al. (2020) measured both systolic and diastolic blood pressure in their participant over a period of 3 months to come to their conclusions. Egan et al. (2018) did the same to assess the effectiveness of BP medications over 6 and 12 months. Both research studies used a HEDIS metric range of <140/90 mm Hg to refer to healthy blood pressure levels.
The NPs can use a HEDIS metric to assess and monitor the patient’s condition over time. HEDIS system has special codes for each pressure level that provides information about the degree of the normalcy of blood pressure in the patient (Casey Jr et al., 2022). For example, according to HEDIS, the highest compliant blood pressure is 139/89 mm Hg. Thus, the NPs can monitor the patient’s blood pressure using this scale throughout the treatment to suggest modifications to it and assess the progress.
Conclusion
High blood pressure remains a widespread cause of more serious illnesses worldwide. However, there are many patient intervention methods to control its levels, including BP medication, physical exercise, and dietary regimen. All these methods are highly effective in lowering blood pressure in patients. Moreover, their effective application can guarantee reduced strain on the healthcare system. NPs can monitor its efficacy using the HEDIS scale to assess the patient’s condition, similar to the scholars researching these methods.
References
Casey Jr, D. E., Daniel, D. M., Bhatt, J., Carey, R. M., Commodore-Mensah, Y., Holmes, A., & Wright Jr, J. T. (2022). Controlling high blood pressure: an evidence-based blueprint for change. American Journal of Medical Quality, 37(1), 22-31. Web.
Cohen, D. J., Wyte-Lake, T., Canfield, S. M., Hall, J. D., Steege, L., Wareg, N. K., & Koopman, R. J. (2022). Impact of home blood pressure data visualization on hypertension medical decision making in primary care. The Annals of Family Medicine, 20(4), 305-311. Web.
Egan, B. M., Sutherland, S. E., Rakotz, M., Yang, J., Hanlin, R. B., Davis, R. A., & Wozniak, G. (2018). Improving Hypertension Control in Primary Care With the Measure Accurately, Act Rapidly, and Partner With Patients Protocol: Results at 6 and 12 Months. Hypertension, 72(6), 1320-1327. Web.
Fu, J., Liu, Y., Zhang, L., Zhou, L., Li, D., Quan, H., & Zhao, Y. (2020). Nonpharmacologic interventions for reducing blood pressure in adults with prehypertension to established hypertension. Journal of the American Heart Association, 9(19). Web.
Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease. Hypertension, 75(2), 285-292. Web.
Hinton, T. C., Adams, Z. H., Baker, R. P., Hope, K. A., Paton, J. F., Hart, E. C., & Nightingale, A. K. (2020). Investigation and treatment of high blood pressure in young people: too much medicine or appropriate risk reduction?. Hypertension, 75(1), 16-22. Web.
