UNDERSTANDING HYPERTENSION

THE ROLE CHWS AND INSTRUCTORS CAN PLAY IN HYPERTENSION WELLNESS AND PREVENTION

Presented by:

Texas AHEC East Coastal Region

CHW Training Organization Approved by the Texas

Department of State Health Services This project is funded in part by “State Public Health Actions to Prevent and Control Diabetes, Heart

Disease, Obesity and Associated Risk Factors and Promote School Health,”

CDC-RFA-DP13-1305, Centers for Disease Control and Prevention, U.S. Department of Health and

Human Services, through Texas Department of State Health Services.

LEARNING OBJECTIVES (CHWS)

1. WHAT IS HYPERTENSION AND HOW IS IT DETERMINED?

2. WHAT ARE THE CAUSES AND RISK FACTORS FOR

HYPERTENSION?

3. WHAT ARE THE CONSEQUENCES OF NOT TREATING

HYPERTENSION?

4. HOW CAN HYPERTENSION BE TREATED OR

PREVENTED?

TEACHING OBJECTIVES (INSTRUCTORS)

• TEACH CHWS TO DEVELOP OBJECTIVES WHEN PRESENTING

HYPERTENSION IN THEIR COMMUNITIES.

• TEACH CHWS TERMINOLOGY AND BLOOD PRESSURE READING

STEPS THAT EMPHASIZE A MORE THOROUGH KNOWLEDGE

BASE AND A HANDS-ON APPROACH.

• CONDUCT HYPERTENSION RESEARCH AND TEACH CHWS TO

IMPLEMENT HYPERTENSION ACTIVITIES WITH ADVOCACY

AND CULTURAL COMPETENCY COMPONENTS IN THEIR OWN

COMMUNITY.

• DEMONSTRATE STRESS-RELIEVING EXERCISES CHWS CAN TAKE

BACK AND SHARE IN THEIR COMMUNITIES.

• PROVIDE CHWS WITH EFFECTIVE TEACHING TECHNIQUES FOR

HYPERTENSION EDUCATION.

HYPERTENSION SELF-ASSESSMENT

1. WHICH OF THE FOLLOWING AFFECTS BLOOD PRESSURE?

a) HOW HARD THE HEART PUMPS

b) HOW NARROW OR WIDE THE BLOOD VESSELS ARE

c) BLOOD VOLUME

d) ALL OF THE ABOVE

2. WHERE IS THE BLOOD PRESSURE HIGHEST?

a) ARTERIES

b) CAPILLARIES

c) VEINS

HYPERTENSION SELF-ASSESSMENT

3. WHAT IS THE SYSTOLIC BLOOD PRESSURE?

a) ARTERIAL BLOOD PRESSURE WHEN THE HEART IS ACTIVELY PUMPING BLOOD

b) ARTERIAL BLOOD PRESSURE WHEN THE HEART IS IN BETWEEN BEATS

c) AVERAGE SUSTAINED CAPILLARY BLOOD PRESSURE OVER ONE MINUTE

d) AVERAGE BLOOD PRESSURE WITHIN THE BRAIN

4. WHAT CATEGORY DOES THE BLOOD PRESSURE 145/82 FALL IN?

a) NORMAL

b) PREHYPERTENSION

c) STAGE 1 HYPERTENSION

d) STAGE 2 HYPERTENSION

HYPERTENSION SELF-ASSESSMENT

5. WHICH OF THE FOLLOWING IS NOT A RISK FACTOR FOR ESSENTIAL HYPERTENSION?

A. FAMILY HISTORY OF HYPERTENSION

B. OBESITY

C. CIGARETTE SMOKING

D. EXCESSIVE ALCOHOL USE

E. PHYSICAL INACTIVITY

F. DEHYDRATION

SELF ASSESSMENT ANSWERS

1. D- ALL OF THE ABOVE

2. A- ARTERIES

3. A- ARTERIAL BLOOD PRESSURE WHEN THE HEART IS ACTIVELY

PUMPING BLOOD

4. C- STAGE 1 HYPERTENSION

5. F- DEHYDRATION

WHAT IS HIGH BLOOD PRESSURE?

• BLOOD PRESSURE IS THE FORCE OF BLOOD PUSHING AGAINST THE WALLS

OF THE ARTERIES AS THE HEART PUMPS BLOOD. IF THIS PRESSURE RISES

AND STAYS HIGH OVER TIME IT CAN DAMAGE THE BODY IN MANY WAYS.

• BLOOD PRESSURE IS MEASURED AS SYSTOLIC AND DIASTOLIC PRESSURES.

• "SYSTOLIC" REFERS TO BLOOD PRESSURE WHEN THE HEART BEATS WHILE

PUMPING BLOOD.

• "DIASTOLIC" REFERS TO BLOOD PRESSURE WHEN THE HEART IS AT REST

BETWEEN BEATS.

• YOU MOST OFTEN WILL SEE BLOOD PRESSURE NUMBERS WRITTEN WITH THE

SYSTOLIC NUMBER ABOVE OR BEFORE THE DIASTOLIC NUMBER, SUCH AS

120/80 MMHG. (THE MMHG IS MILLIMETERS OF MERCURY—THE UNITS USED

TO MEASURE BLOOD PRESSURE.)

OTHER NAMES FOR HBP

• HYPERTENSION

• WHEN HBP HAS NO KNOWN CAUSE, IT MIGHT BE CALLED ESSENTIAL

HYPERTENSION, PRIMARY HYPERTENSION, OR IDIOPATHIC

HYPERTENSION.

• WHEN ANOTHER CONDITION CAUSES HBP, IT'S SOMETIMES CALLED

SECONDARY HYPERTENSION.

• ISOLATED SYSTOLIC HYPERTENSION (ISH) IS WHEN ONLY THE

SYSTOLIC PRESSURE IS HIGH

• MANY OLDER ADULTS HAVE THIS CONDITION. ISH CAN CAUSE AS MUCH

HARM AS HBP IN WHICH BOTH NUMBERS ARE TOO HIGH

CATEGORIES FOR BLOOD PRESSURE IN ADULTS

Category Systolic

(top number)

Diastolic

(bottom number)

Normal Less than 120 And Less than 80

Prehypertension 120-139 Or 80-89

High blood pressure

Stage 1 140-159 Or 90-99

Stage2 160 or higher Or 100 or higher

The table below shows normal blood pressure ranges for adults. It also shows

which numbers put you at greater risk for health problems.

HYPERTENSION BASICS

• BLOOD PRESSURE DOESN'T STAY THE SAME ALL THE TIME. IT LOWERS AS YOU

SLEEP AND RISES WHEN YOU WAKE UP. BLOOD PRESSURE ALSO RISES WHEN

YOU'RE EXCITED, NERVOUS, OR ACTIVE AND TENDS TO RISE WITH AGE.

• IF YOUR NUMBERS STAY ABOVE NORMAL MOST OF THE TIME, YOU'RE AT RISK FOR

HEALTH PROBLEMS.

• IF YOU'RE BEING TREATED FOR HBP AND HAVE REPEAT READINGS IN THE NORMAL

RANGE, YOUR BLOOD PRESSURE IS UNDER CONTROL. HOWEVER, YOU STILL HAVE

THE CONDITION.

• YOUR SYSTOLIC AND DIASTOLIC NUMBERS MAY NOT BE IN THE SAME BLOOD

PRESSURE CATEGORY. THE MORE SEVERE CATEGORY IS THE ONE YOU'RE IN. FOR

EXAMPLE, IF YOUR SYSTOLIC NUMBER IS 160 AND YOUR DIASTOLIC NUMBER IS

80, YOU HAVE STAGE 2 HBP. IF YOUR SYSTOLIC NUMBER IS 120 AND YOUR

DIASTOLIC NUMBER IS 95, YOU HAVE STAGE 1 HBP.

LEARNING ACTIVITY (CHWS)

TERMINOLOGY (INSTRUCTORS)

• SPHYGMOMANOMETER: AN INSTRUMENT FOR MEASURING

BLOOD PRESSURE, TYPICALLY CONSISTING OF AN INFLATABLE RUBBER

CUFF THAT IS APPLIED TO THE ARM AND CONNECTED TO A COLUMN

OF MERCURY NEXT TO A GRADUATED SCALE, ENABLING THE

DETERMINATION OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE BY

INCREASING AND GRADUALLY RELEASING THE PRESSURE IN THE CUFF.

• KOROTKOFF SOUNDS: ARTERIAL SOUNDS HEARD THROUGH A

STETHOSCOPE APPLIED TO THE BRACHIAL ARTERY DISTAL TO THE CUFF

OF A SPHYGMOMANOMETER THAT CHANGE WITH VARYING CUFF

PRESSURE AND THAT ARE USED TO DETERMINE SYSTOLIC AND

DIASTOLIC BLOOD PRESSURE.

LEARNING ACTIVITY (INSTRUCTORS)

SYMPTOMS AND MYTHS OF HYPERTENSION

• ONE OF THE MOST DANGEROUS ASPECTS OF HYPERTENSION IS THAT IT

IS ASYMPTOMATIC. MEANING PEOPLE MAY NOT KNOW THAT THEY HAVE

IT.

• NEARLY ONE-THIRD OF PEOPLE WHO HAVE HIGH BLOOD PRESSURE

DON'T KNOW IT.

• BE AWARE OF COMMON SYMPTOMATIC MYTHS OR MISCONCEPTIONS.

THEY INCLUDE:

• HEADACHES

• NOSEBLEEDS

• BLOOD SPOTS IN THE EYE

• FACIAL FLUSHING

• DIZZINESS

CAUSE VS RISK FACTOR

• WHEN TALKING TO CLIENTS IT’S IMPORTANT TO BE ABLE

TO EXPLAIN THE DIFFERENCE BETWEEN CAUSE AND RISK

FACTOR.

• CAUSE IS DEFINED AS A CAUSE THAT DIRECTLY OR WITH

NO INTERVENING AGENCY PRODUCES AN EFFECT.

EXAMPLE, HIV IS THE CAUSE, AIDS IS THE EFFECT;

• RISK FACTOR IS DEFINED AS SOMETHING THAT INCREASES

YOUR CHANCES OF GETTING A DISEASE. SOMETIMES,

THIS RISK COMES FROM SOMETHING YOU DO.

CAUSES OF HYPERTENSION

PRIMARY (ESSENTIAL) HYPERTENSION

FOR MOST ADULTS, THERE'S NO IDENTIFIABLE CAUSE OF HIGH

BLOOD PRESSURE. THIS TYPE OF HIGH BLOOD PRESSURE,

CALLED ESSENTIAL HYPERTENSION OR PRIMARY HYPERTENSION,

TENDS TO DEVELOP GRADUALLY OVER MANY YEARS.

CAUSES OF HYPERTENSION

SECONDARY HYPERTENSION

SOME PEOPLE HAVE HIGH BLOOD PRESSURE CAUSED BY AN UNDERLYING

CONDITION. THIS TYPE OF HIGH BLOOD PRESSURE, CALLED SECONDARY

HYPERTENSION, TENDS TO APPEAR SUDDENLY AND CAUSE HIGHER

BLOOD PRESSURE THAN DOES PRIMARY HYPERTENSION. VARIOUS

CONDITIONS AND MEDICATIONS CAN LEAD TO SECONDARY

HYPERTENSION, INCLUDING:

• KIDNEY PROBLEMS

• ADRENAL GLAND TUMORS

• CERTAIN DEFECTS IN BLOOD VESSELS YOU'RE BORN WITH (CONGENITAL)

• CERTAIN MEDICATIONS, SUCH AS BIRTH CONTROL PILLS, COLD REMEDIES,

DECONGESTANTS, OVER-THE-COUNTER PAIN RELIEVERS AND SOME

PRESCRIPTION DRUGS

• ILLEGAL DRUGS, SUCH AS COCAINE AND AMPHETAMINES

CONTROLLABLE RISK FACTORS

• OVERWEIGHT / OBESITY

• NOT BEING PHYSICALLY

ACTIVE.

• USING TOBACCO

• TOO MUCH SALT

(SODIUM) IN YOUR DIET

• TOO LITTLE POTASSIUM IN

YOUR DIET

• EXCESSIVE USE OF

ALCOHOL

• STRESS

RISKS THAT CANNOT BE CONTROLLED

• 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

AFRICAN-AMERICANS, OFTEN DEVELOPING AT AN EARLIER AGE THAN IT

DOES IN OTHER RACES. SERIOUS COMPLICATIONS, SUCH AS STROKE AND

HEART ATTACK, ALSO ARE MORE COMMON AMONG AFRICAN-

AMERICANS.

• FAMILY HISTORY. HIGH BLOOD PRESSURE TENDS TO RUN IN FAMILIES.

• CERTAIN CHRONIC CONDITIONS. CERTAIN CHRONIC CONDITIONS ALSO

MAY INCREASE YOUR RISK OF HIGH BLOOD PRESSURE, INCLUDING HIGH

CHOLESTEROL, DIABETES, KIDNEY DISEASE AND SLEEP APNEA.

IMPROVING CULTURAL COMPETENCY USING HYPERTENSION TEACHING (INSTRUCTORS)

• HAVE STUDENTS RESEARCH HYPERTENSION TRENDS IN THEIR

LOCAL COMMUNITY (ONLINE, LOCAL HEALTH DEPARTMENTS, ETC).

HAVE THEM FIND ANSWERS TO THE FOLLOWING QUESTIONS:

• ARE THERE DIFFERENCES IN HYPERTENSION RATES AMONG

GEOGRAPHICAL AREAS IN THEIR COMMUNITY?

• ARE THERE DIFFERENCES IN HYPERTENSION RATES ALONG

ETHNIC, RACIAL, OR CULTURAL LINES IN THEIR COMMUNITY?

• WHAT KIND OF ACCESS TO SCREENINGS, PREVENTION

PROGRAMS, AND TREATMENTS DO MEMBERS OF THE

COMMUNITY HAVE? IS ACCESS EASIER OR MORE DIFFICULT

FOR CERTAIN POPULATIONS IN THEIR COMMUNITY?

TREATMENT GOALS (AS DETERMINED BY YOUR DOCTOR)

• YOUR BLOOD PRESSURE TREATMENT GOAL DEPENDS ON HOW

HEALTHY YOU ARE.

• BLOOD PRESSURE TREATMENT GOALS 140/90 MM HG OR LOWER IF

YOU ARE A HEALTHY ADULT

• 130/80 MM HG OR LOWER IF YOU HAVE CHRONIC KIDNEY DISEASE,

DIABETES OR CORONARY ARTERY DISEASE OR ARE AT HIGH RISK OF

CORONARY ARTERY DISEASE

• 120/80 MM HG OR LOWER IF YOUR HEART ISN'T PUMPING AS WELL

AS IT SHOULD (LEFT VENTRICULAR DYSFUNCTION OR HEART FAILURE) OR

YOU HAVE SEVERE CHRONIC KIDNEY DISEASE

TREATMENT

• HIGH BLOOD PRESSURE (HBP) IS TREATED WITH LIFESTYLE

CHANGES AND MEDICINES.

• MOST PEOPLE WHO HAVE HBP WILL NEED LIFELONG

TREATMENT. STICKING TO A TREATMENT PLAN IS

IMPORTANT.

LIFESTYLE CHANGES

• HEALTHY LIFESTYLE HABITS CAN HELP YOU CONTROL HBP.

THESE HABITS INCLUDE:

• FOLLOWING A HEALTHY DIET

• BEING PHYSICALLY ACTIVE

• MAINTAINING A HEALTHY WEIGHT

• QUITTING SMOKING

• MANAGING YOUR STRESS AND LEARNING TO COPE WITH

STRESS

DIETARY APPROACHES TO STOP HYPERTENSION (DASH) EATING PLAN

• SCIENTISTS SUPPORTED BY THE NATIONAL HEART, LUNG, AND BLOOD

INSTITUTE (NHLBI) CONDUCTED TWO KEY STUDIES. THEIR FINDINGS

SHOWED THAT BLOOD PRESSURES WERE REDUCED WITH AN EATING PLAN

THAT IS:

• LOW IN SATURATED FAT, CHOLESTEROL, AND TOTAL FAT

• EMPHASIZES FRUITS, VEGETABLES, AND FAT-FREE OR LOW-FAT MILK AND MILK

PRODUCTS.

• INCLUDES WHOLE GRAIN PRODUCTS, FISH, POULTRY, AND NUTS.

• IT IS REDUCED IN LEAN RED MEAT, SWEETS, ADDED SUGARS, AND SUGAR-

CONTAINING BEVERAGES

• RICH IN POTASSIUM MAGNESIUM, AND CALCIUM, AS WELL AS PROTEIN AND

FIBER.

PHYSICAL ACTIVITY

• ROUTINE PHYSICAL ACTIVITY CAN LOWER HBP AND REDUCE THE RISK FOR

OTHER HEALTH PROBLEMS.

• PEOPLE GAIN HEALTH BENEFITS FROM AS LITTLE AS 60 MINUTES OF

MODERATE-INTENSITY AEROBIC ACTIVITY PER WEEK.

• THE MORE ACTIVE, THE MORE BENEFIT.

• ALWAYS ADVISE CLIENTS TO TALK WITH THEIR DOCTOR BEFORE STARTING

A NEW EXERCISE PLAN.

• QUESTIONS TO ASK MIGHT INCLUDE:

• HOW MUCH AND WHAT KINDS OF PHYSICAL ACTIVITY ARE SAFE?

• ARE THERE ANY RESTRICTION DUE TO MY PAST HEART DIAGNOSIS?

HEALTHY WEIGHT

• LOSING EVEN 5 POUNDS (2.3 KILOGRAMS) CAN LOWER

YOUR BLOOD PRESSURE.

• ONE POUND EQUALS 3,500 CALORIES. SO, TO LOSE 1

POUND A WEEK, YOU NEED TO EAT 500 CALORIES A DAY

LESS OR BURN 500 CALORIES A DAY MORE THAN YOU

USUALLY DO.

BMI CHART

SMOKING CESSATION

• PEOPLE WHO SMOKE ARE UP TO SIX TIMES MORE LIKELY TO

SUFFER A HEART ATTACK THAN NONSMOKERS, AND THE RISK

INCREASES WITH THE NUMBER OF CIGARETTES SMOKED EACH

DAY.

• SMOKERS ARE LIKELY TO SUFFER A HEART ATTACK OR OTHER

MAJOR HEART PROBLEM AT LEAST 10 YEARS SOONER THAN

NONSMOKERS.

• TOBACCO INJURES BLOOD VESSEL WALLS AND SPEEDS UP

THE PROCESS OF HARDENING OF THE ARTERIES.

STRESS MANAGEMENT

THE BODY’S STRESS RESPONSE

• STRESS IS A RISK FACTOR

• WHEN YOU PERCEIVE A THREAT, YOUR NERVOUS SYSTEM RESPONDS BY

RELEASING A FLOOD OF STRESS HORMONES, INCLUDING ADRENALINE

AND CORTISOL. THESE HORMONES ROUSE THE BODY FOR EMERGENCY

ACTION.

• YOUR HEART POUNDS FASTER, MUSCLES TIGHTEN, BLOOD PRESSURE RISES,

BREATH QUICKENS, AND YOUR SENSES BECOME SHARPER. THESE PHYSICAL

CHANGES INCREASE YOUR STRENGTH AND STAMINA, SPEED YOUR

REACTION TIME, AND ENHANCE YOUR FOCUS – PREPARING YOU TO

EITHER FIGHT OR FLEE FROM THE DANGER AT HAND.

SIGNS OF STRESS

• IRRITABILITY - FRUSTRATION

• OVERREACTING TO MINOR DISTURBANCES

• LOSING YOUR TEMPER MORE FREQUENTLY

• FEELING JUMPY OR EXHAUSTED ALL THE TIME

• DIFFICULTY CONCENTRATING OR FOCUSING

• WORRYING ABOUT INSIGNIFICANT THINGS

STRESS SELF-ASSESSMENT: THE HOLMES-RAHE LIFE STRESS INVENTORY

HOLMES-RAHE LIFE STRESS INVENTORY

• 150 POINTS OR LESS – LOW SUSCEPTIBILITY TO STRESS-

RELATED HEALTH PROBLEMS

• 150-300 POINTS – IMPLIES ABOUT A 50% CHANCE TO

DEVELOP STRESS-RELATED HEALTH PROBLEMS IN THE NEXT

TWO YEARS

• 300+ POINTS – RAISES THE CHANCE TO ABOUT 80%,

ACCORDING TO THE HOLMES-RAHE PREDICTION MODEL

UNHEALTHY WAYS TO DEAL WITH STRESS

• SMOKING

• DRINKING TOO MUCH

• OVEREATING OR UNDEREATING

• ZONING OUT FOR HOURS IN FRONT OF THE TV OR COMPUTER

• WITHDRAWING FROM FRIENDS, FAMILY, AND ACTIVITIES

• USING PILLS OR DRUGS TO RELAX

• SLEEPING TOO MUCH

• PROCRASTINATING

• FILLING UP EVERY MINUTE OF THE DAY TO AVOID FACING PROBLEMS

• TAKING OUT YOUR STRESS ON OTHERS (LASHING OUT, ANGRY

OUTBURSTS, PHYSICAL VIOLENCE)

STRESS MANAGEMENT STRATEGY # 1

• AVOID THE STRESSOR

• SAY NO WHEN YOUR PLATE IS FULL

• AVOID PEOPLE WHO STRESS YOU OUT

• AVOID HOT-TOPIC ISSUES

• PARE DOWN YOUR TO-DO LIST

• CONTROL YOUR ENVIRONMENT

STRESS MANAGEMENT STRATEGY #2

• ALTER THE SITUATION

• PLAN AHEAD SO YOU DON’T OVEREXTEND

YOURSELF.

• EXPRESS YOUR FEELINGS RATHER THAN BOTTLE THEM

UP.

• BE MORE ASSERTIVE ABOUT YOUR TIME.

STRESS MANAGEMENT STRATEGY #3

• ADAPT TO THE STRESSOR

• LEARN TO ENJOY TRAFFIC JAMS

• LOOK AT THE BIG PICTURE

• ADJUST YOUR STANDARDS

• REFLECT ON THE POSITIVE THINGS IN YOUR LIFE

STRESS MANAGEMENT STRATEGY #4

• ACCEPT THE THINGS YOU CANNOT CHANGE

• DON’T TRY TO CONTROL THE UNCONTROLLABLE

• LOOK FOR THE UPSIDE

• LEARN TO FORGIVE

• SHARE YOUR FEELINGS

STRESS MANAGEMENT #5

MAKE TIME FOR FUN AND RELAXATION!

• GO FOR A WALK.

• SPEND TIME IN NATURE.

• CALL A GOOD FRIEND.

• SWEAT OUT TENSION WITH A

GOOD WORKOUT.

• WRITE IN YOUR JOURNAL.

• TAKE A LONG BATH.

• LIGHT SCENTED CANDLES.

• SAVOR A WARM CUP OF COFFEE

OR TEA.

• PLAY WITH A PET.

• WORK IN YOUR GARDEN.

• GET A MASSAGE.

• CURL UP WITH A GOOD BOOK.

• LISTEN TO MUSIC.

• WATCH A COMEDY.

PRACTICE WHAT YOU PREACH!

(INSTRUCTORS)

RESERVE SOME CLASS TIME TO DO SOME STRESS-

RELIEVING EXERCISES:

• GO FOR A WALK AROUND THE BUILDING.

• SIT AND BE FIT! (STRETCH BANDS, EXERCISE BALLS, ETC.)

• ALLOW 10 MINUTES TO WRITE IN A JOURNAL.

• GUIDED MEDITATION.

• BACKGROUND MUSIC DURING BREAKS OR RECESS.

• HAVE CLASS OUTSIDE ONE DAY!

DRUGS AND MEDICATION

• WHEN BLOOD PRESSURE IS 140 OR HIGHER FOR YOUR SYSTOLIC

PRESSURE (TOP NUMBER) OR 90 OR HIGHER FOR YOUR DIASTOLIC

PRESSURE (BOTTOM NUMBER), HEALTHCARE PROVIDERS WILL LIKELY

PRESCRIBE MEDICATION IN ADDITION TO LIFESTYLE MODIFICATIONS.

• MORE THAN ONE TYPE OF PRESCRIPTION MEDICATION TO KEEP YOUR

BLOOD PRESSURE AT A HEALTHY LEVEL.

• BLOOD PRESSURE MEDICINES WORK IN DIFFERENT WAYS TO LOWER

BLOOD PRESSURE. SOME REMOVE EXTRA FLUID AND SALT FROM THE

BODY TO LOWER BLOOD PRESSURE. OTHERS SLOW DOWN THE

HEARTBEAT OR RELAX AND WIDEN BLOOD VESSELS.

BROAD CATEGORIES OF MEDICATION FOR CLIENTS

DIURETICS - SOMETIMES CALLED "WATER PILLS" BECAUSE THEY WORK IN THE KIDNEY AND

FLUSH EXCESS WATER AND SODIUM FROM THE BODY.

BETA-BLOCKERS - BETA-BLOCKERS REDUCE NERVE IMPULSES TO THE HEART AND BLOOD

VESSELS. THIS MAKES THE HEART BEAT SLOWER AND WITH LESS FORCE. BLOOD PRESSURE

DROPS AND THE HEART WORKS LESS HARD.

ACE INHIBITORS - ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS PREVENT THE

FORMATION OF A HORMONE CALLED ANGIOTENSIN II, WHICH NORMALLY CAUSES BLOOD

VESSELS TO NARROW. THE ACE INHIBITORS CAUSE THE VESSELS TO RELAX AND BLOOD

PRESSURE GOES DOWN.

ANGIOTENSIN ANTAGONISTS - ANGIOTENSIN ANTAGONISTS SHIELD BLOOD VESSELS FROM

ANGIOTENSIN II. AS A RESULT, THE VESSELS BECOME WIDER AND BLOOD PRESSURE GOES

DOWN.

BROAD CATEGORIES OF MEDICATION FOR CLIENTS

CALCIUM CHANNEL BLOCKERS (CCBS) - CCBS KEEP CALCIUM FROM ENTERING THE MUSCLE

CELLS OF THE HEART AND BLOOD VESSELS. THIS CAUSES THE BLOOD VESSELS TO RELAX

AND PRESSURE GOES DOWN.

ALPHA-BLOCKERS - REDUCE NERVE IMPULSES TO BLOOD VESSELS, WHICH ALLOWS BLOOD

TO PASS MORE EASILY, CAUSING THE BLOOD PRESSURE TO GO DOWN.

ALPHA-BETA-BLOCKERS - WORK THE SAME WAY AS ALPHA-BLOCKERS BUT ALSO SLOW

THE HEARTBEAT, AS BETA-BLOCKERS DO. AS A RESULT, LESS BLOOD IS PUMPED THROUGH

THE VESSELS AND THE BLOOD PRESSURE GOES DOWN.

NERVOUS SYSTEM INHIBITORS - RELAX BLOOD VESSELS BY CONTROLLING NERVE

IMPULSES. THIS CAUSES THE BLOOD VESSELS TO BECOME WIDER AND THE BLOOD

PRESSURE TO GO DOWN.

VASODILATORS - DIRECTLY OPEN BLOOD VESSELS BY RELAXING THE MUSCLE IN THE VESSEL

WALLS, CAUSING THE BLOOD PRESSURE TO GO DOWN.

HYPERTENSION AND WOMEN

• THREE OUT OF FOUR WOMEN WITH HIGH BLOOD PRESSURE KNOW

THEY HAVE IT.

• FEWER THAN ONE IN THREE ARE CONTROLLING THEIR BLOOD

PRESSURE. ALL WOMEN SHOULD TAKE STEPS TO CONTROL THEIR

BLOOD PRESSURE

• CERTAIN CONDITIONS CAN INCREASE BLOOD PRESSURE IN WOMEN.

• PREGNANCY

• ORAL CONTRACEPTIVES

• HORMONE REPLACEMENT THERAPY

ESSENTIAL COPING AND SUPPORT

HIGH BLOOD PRESSURE ISN'T A PROBLEM THAT YOU CAN TREAT AND THEN IGNORE. IT'S A

CONDITION YOU NEED TO MANAGE FOR THE REST OF YOUR LIFE. TO KEEP YOUR

BLOOD PRESSURE UNDER CONTROL:

TAKE YOUR MEDICATIONS PROPERLY. IF SIDE EFFECTS OR COSTS POSE PROBLEMS, DON'T

STOP TAKING YOUR MEDICATIONS. ASK YOUR DOCTOR ABOUT OTHER OPTIONS.

SCHEDULE REGULAR DOCTOR VISITS. IT TAKES A TEAM EFFORT TO TREAT HIGH BLOOD

PRESSURE SUCCESSFULLY. YOUR DOCTOR CAN'T DO IT ALONE, AND NEITHER CAN YOU.

WORK WITH YOUR DOCTOR TO BRING YOUR BLOOD PRESSURE TO A SAFE LEVEL —

AND KEEP IT THERE.

ADOPT HEALTHY HABITS. EAT HEALTHY FOODS, LOSE EXCESS WEIGHT AND GET REGULAR

PHYSICAL ACTIVITY. LIMIT ALCOHOL. IF YOU SMOKE, QUIT.

MANAGE STRESS. SAY NO TO EXTRA TASKS, RELEASE NEGATIVE THOUGHTS, MAINTAIN

GOOD RELATIONSHIPS, AND REMAIN PATIENT AND OPTIMISTIC.

STICKING TO LIFESTYLE CHANGES CAN BE DIFFICULT — ESPECIALLY IF YOU

DON'T SEE OR FEEL ANY SYMPTOMS OF HIGH BLOOD PRESSURE.

TEACHING HYPERTENSION (INSTRUCTORS)

• THE BLOOD PRESSURE MONITOR EXERCISE IS A GREAT HANDS-

ON ACTIVITY THAT WILL TEACH CHWS HOW TO EFFECTIVELY DO

A BLOOD PRESSURE SCREENING. PARTICULARLY EFFECTIVE WITH

TACTILE / KINISTHETIC LEARNERS.

• VISUAL LEARNERS WILL BENEFIT FROM THE MULTIPLE RESOURCES

AVAILABE AT HTTP://WWW.NHLBISUPPORT.COM/

• HAVE STUDENTS RESEARCH AND DEVELOP A RESOURCE LIBRARY

CONTAINING LOCAL AGENCIES, HEALTH DEPARTMENTS, ETC. THAT

PROVIDE MEDICAL AND SOCIAL SUPPORT FOR AT-RISK CLIENTS.

RESOURCES

• THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (PRIMARY SOURCE)

HTTP://WWW.NHLBI.NIH.GOV/

• YOUR GUIDE TO LOWERING BLOOD PRESSURE (DASH)

HTTPS://WWW.NHLBI.NIH.GOV/FILES/DOCS/PUBLIC/HEART/HBP_LOW.PDF

• HIGH BLOOD PRESSURE CONTROL

HTTP://WWW.NHLBI.NIH.GOV/HEALTH/PUBLIC/HEART/HBP/HBPWALLET.PDF

• BMI CALCULATOR

HTTP://WWW.NHLBISUPPORT.COM/BMI/

• MENU PLANNER

HTTP://HP2010.NHLBIHIN.NET/MENUPLANNER/MENU.CGI

RESOURCES

• 10 YEAR CVD RISK CALCULATOR

HTTP://HP2010.NHLBIHIN.NET/ATPIII/CALCULATOR.ASP?USE

RTYPE=PUB

• SMOKING CESSATION

HTTP://WWW.CANCER.ORG/HEALTHY/TOOLSANDCALCUL

ATORS/CALCULATORS/APP/SMOKING-COST-

CALCULATOR.ASPX

• DASH EATING PLAN

HTTP://WWW.NDHEALTH.GOV/HEARTSTROKE/IMAGE/CAC

HE/FACTS_ABOUT_THE_DASH_EATING_PLAN.PDF

PRE- AND POST-TESTING