Answer Happy

HIGH BLOOD PRESSURE: A PUBLIC HEALTH AND HEALTHCARE SUCCESS mit yours individuals with elevated blood pressure respond to drug treatment with tolerable or no side effects, but need to continue treatment for many years-usually for the rest of their lives A national pablic health campaign began in the 19705 to encourage individuals to know their blood pressure and to urge dinicians to treat detected elevated levels in recent decades, national surveys have indicated that a gradually Increasing percentage of patients with elevated blood pres sures are being successfully treated and that there has been a substantial reduction in strokes and deaths from strokes Recent evidence showing that reducing the high salt levels in the US. diet can reduce the average level of blood pressure has prompted renewed public health efforts to change eating habits and the contents of commercial foods Today, treatment of high blood pressure is recognized as one of the most cost-effective interventions. It cost per quality adjusted life-year (QALY) saved is only a few thou sand dollars a year for the average person. For high-risk groups, such as those with diabetes, it actually saves money to monitor and treat high blood pressure rather than allow it to cause of exacerbate other health problems requiring more expensive treatments Elevated levels of blood pressure, or hypertension, have been served since the development of blood pressure measure ents in the 1800s. It was soon recognized that populations with a high frequency of elevated blood pressure were also populations with a high frequency of strokes, yet the dan con of high blood pressure often went unappreciated until High blood pressure is a condition that historically has tected both the privileged and the underprivileged in our dy. Presidents Woodrow Wilson and Frankdin Delano Roosevelt both had high blood pressure and suffered strokes procent among African Americans--15 to 20% have some and heart disease. Today, the condition is disproportionately degree of elevated blood pressure. For many years, high blood pressure was considered a unsuence of disease rather than its cause. Clinicians see ing a patient with a stroke, for instance, often attributed their devation in blood pressure to the stroke rather than the other way round. Long-term studies, such as the Framingham Hart Study, which followed a large number of individuals for many years established that the high blood pressure Actually preceded strokes and not the other way around. High blood pressure as a contributory cause of strokes, as well as heart and kidney disease, was fully confirmed only after randomized controlled trials in the late 1960x and early 1970s established that lower blood pressure leads to reduced frequency of these diseases. Screening for high blood pres- sure became widespread in the same period in large part as a result of these investigations Elevated levels were initially defined as 140/100 DE greater, based upon a range of normal obtained by measur ing the blood pressure on large numbers of adult Americans What were once considered acceptable levels of blood pres sure have been redefined as elevated levels in recent years Today, the desirable level is considered 120/80 or lower These changing levels are justified by follow up data from a large number of individuals that demonstrates that even level of blood pressure only slightly above 120/80 are associ med with increased risk of stroke and heart disease. The fluctuating levels of blood pressure often make it cult to establish an individual's average level, Electronic minitoring of blood pressure over a 24-hour period has Sertime a feasible and acceptable gold standard for estab Naching in individual's average level. Early detection and acesful treatments have been shown to effectively reduce The consequences of high blood pressure. Weight loss and Het betriction are often prescribed initially, with subse- Vest introduction of one or more drugs. Most, if not all Discussion Questions 1. How does this history of high blood pressure dem onstrate the problem description and etiology.com ponents of the PERLE process? What different types of studies were used to establish etiology or contributory cause 2. How does this history of high blood pressure illus- trate the evidence-based recommendations and implementation and evaluation components of the PERLE process! 3. Explain the justification for updating the definition of what is considered a healthy blood pressure level 4. How does this history of high blood pressure dem onstrate the application of the four criteria fora successful screening program? Explain. 5. Using the four quadrants of cost and effectiveness how would you dassily treatment of hypertension for the average person? For those with diabetes? Explain TESTING AND SCREENING Ken had just turned 40, and with a little encouragement from his wife, he decided that it was time to have a physical - would be his first real visit to a doctor since he broke his arm