Treatment Plans for Hypertension
Hypertension (or high blood pressure) is a chronic illness associated with elevated blood pressure levels. Although hypertension is asymptomatic, patients exposed to the long-term condition are at higher risk of experiencing related co-morbidities, including heart failure, chronic kidney disease, coronary artery disease, vision loss, stroke, dementia, peripheral arterial disease, and atrial fibrillation. Although the cause of high blood pressure is still inconclusive, studies have also shown that a sedentary lifestyle can predispose individuals to the condition, including alcohol use, smoking, too much salt in food, and excess body weight. These are broadly classified as primary factors, and they are responsible for nearly 90-95 percent of all incidences. Secondary factors, such as endocrine disorder, thinning of kidney arteries, use of birth contraceptives, and chronic kidney disease, cause the other 5-10 percent. It is estimated that at least 1.13 billion people live with hypertension, with 75 percent of this population in middle- and low-income democracies (WHO, 2019). This prevalence has been the main reason why several therapies have been developed to combat its effects and complications. This paper will explore the prescription and non-prescription therapies/medications used to treat hypertension, how to monitor the drug administration process, the adverse effects and indications, and the desired outcomes. An appropriate pharmaceutical treatment plan and considerations for various populations will also be evaluated.
Prescription and Non-prescription Therapies/Medications
Treatment plans for hypertension are classified into two: non-prescription and prescription. Non-prescription treatment plans are those that ideally refer to the preventive measures used to lower the risk of raising blood pressure levels above the ideal range of 90/60 mmHg and 120/80 mmHg. Some of these non-prescription measures, which are often intended to address the risk factors, include maintaining the body mass index between 25 and 25, keeping dietary intake of salt below 100 mmol per day, engaging in a 30-min aerobic exercise per day, limiting alcohol intake to less than 2 units/day and 3 units/day for women and men, respectively, as well as consuming at least 5 portions per day of vegetables and fruits (Unger et al., 2020). Other recommended non-prescription techniques include increasing dietary potassium intake by ingesting potassium supplements. Also, stress reduction methods like transcendental meditation and biofeedback have been shown to lower hypertension.
The second form of treatment involves the use of prescription medications. Generally, antihypertensives are the collective group of drugs used to treat high blood pressure. Usually, the first-line drugs for high blood pressure include ARBs (angiotensin receptor blockers), channel calcium blockers, thiazide-diuretics, and ACE inhibitors (angiotensin-converting enzyme inhibitors). These pharmaceutical elements are prescribed alone or given as a combo (except for ARBs and ACE inhibitors). These antihypertensives act by either blocking the release of angiotensin II (ACE inhibitors) and its receptors (ARBs) or encouraging vasodilation by obstructing the sympatholytics or the sympathetic adrenergic vascular tone (diuretics). A majority of people often need more than one drug to bring down their blood pressure levels. Although beta-blockers were also previously used to control hypertension, a 2017 Cochrane study identified that these groups of drugs, such as atenolol, are ineffective compared to other antihypertensive therapies (Wiysonge et al., 2017).
Monitoring, Adverse Effects, Drug Interactions, and Desired Outcomes of Pharmaceutical Agents
Monitoring individuals placed on antihypertensives is critical in identifying potential adverse reactions and drug interactions. The common adverse reactions associated with antihypertensives, especially ACE inhibitors and diuretics, include dry irritating coughs, dizziness, excessive micturition, and frequent headaches and micturition (Olowofela & Isah, 2017). For monitoring, the serum levels of creatinine and potassium are supposed to be tracked whenever patients are taking antihypertensives. The serum potassium levels should be kept below 5.0 mmol per liter and should be checked within one week after the patient starts the antihypertensive medication. On the other hand, serum creatinine levels should be kept below 30 percent. In most instances, interactions with NSAIDs (non-steroidal anti-inflammatory drugs) can raise levels of creatinine. Potassium supplements can also interact with antihypertensives to increase the levels of serum potassium. Finally, it is important to note that the ultimate goal or desired pharmaceutical outcomes of hypertension therapy (both prescription and non-description) is to keep blood pressure levels within the normal ranges of between 90/60 mmHg and 120/80 mmHg. Anything above the 120/80 mmHg mark is considered undesirable.
Appropriate Pharmaceutical Treatment Plan
Usually, the recommended or the most preferred first-line treatment for high blood pressure is a diuretic or a beta-blocker – which should be prescribed at a low dosage. Studies have shown that using monotherapy can achieve a blood pressure level of below 140/90 mm Hg, with a success rate of nearly 50 percent. Combining two pharmaceutical agents is often needed to adequately lower blood pressure levels (below 120/80 mm Hg). Using a single-dose combo is paramount due to its high efficacy in lowering blood pressure levels and its ability to produce fewer adverse effects. Some antihypertensive combinations include diuretics and beta-blockers, diuretics, and ACE inhibitors. The only exceptions are ACE inhibitors and ARBs (Wiysonge et al., 2017).
Considerations for Various Populations
When prescribing antihypertensives, certain aspects must be taken into consideration. For example, beta-blockers are never recommended for older adults aged 60 years and above. This is only possible if they have an underlying condition that compels them to use these drugs (Benetos, Petrovic, & Strandberg, 2019).
Conclusion
Hypertension is a chronic illness associated with elevated blood pressure levels. Because of its prevalence, several therapies (both non-prescription and prescription) have been developed to address the potential causes and risk factors. Non-prescription treatment plans are ideally the preventive measures used to lower the risk of raising blood pressure levels above the ideal range of 90/60 mmHg and 120/80 mmHg. They include dietary plans, regular exercise, and so on. On the other hand, prescription methods involve the use of four main pharmaceutical agents, including ACE inhibitors, ARBs, channel calcium blockers, and thiazide diuretics. Single-dose medications are the most preferred means of treating blood pressure, although a combination of these elements is also sometimes used.
References
Benetos, A., Petrovic, M., & Strandberg, T. (2019). Hypertension management in older and frail older patients. Circulation Research, 124(7). https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313236
Olowofela, A. O., & Isah, A. O. (2017). A profile of adverse effects of antihypertensive medicines in a tertiary care clinic in Nigeria. Annals of African Medicine, 16(3), 114-119. doi: 10.4103/aam.aam_6_17
Unger, T., et al. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334-1357. doi:10.1161/HYPERTENSIONAHA.120.15026
WHO. (2019). Hypertension. Retrieved from https://www.who.int/news-room/fact-sheets/detail/hypertension#:~:text=An%20estimated%201.13%20billion%20people,cause%20of%20premature%20death%20worldwide
Wiysonge, C. S., et al. (2017). Beta-blockers for hypertension. The Cochrane Database of Systematic Reviews, 1, CD002003. doi:10.1002/14651858.CD002003.pub5
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Question 
Treatment Plans for Hypertension
Select a disease or condition. For example, sepsis, CAD, HCAP, HAP, hypertension, CHF, atrial fibrillation, depression, Parkinson’s disease, hyperlipidemia, COPD, asthma, and febrile neutropenia.
Treatment Plans for Hypertension
Write a 750-1,000 word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease. Discuss monitoring and identify significant adverse effects and drug-drug interactions, as well as desired outcomes of the pharmacological agents used in the treatment of the disease. Determine an appropriate pharmaceutical treatment plan for the disease or condition. Incorporate considerations for various populations (geriatrics, pediatrics) depending on the disease you have selected.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.