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Nursing assignment 991

Reply to my peers Peer 1 Initial Post: Blood pressure is the measurement of pressure in the cardiovascular system during the heart’s pumping cycle.  Everybody’s blood pressure varies from many factors, time of day, weight, and age could be the main causes of blood pressure. There are two types of blood regulation: short term and long term. Short term regulation is controlled by the autonomic nervous system. The sympathetic outflow is being regulated by “feedback mechanisms” (Dampney, 2002) Meanwhile long term regulation has ties with the renin-angiotensin system. (n.d.) Hypertension is referred to as just high blood pressure. It is very common in the United States due to the high levels of obesity. There are many factors that cause hypertension, the three I’m choosing are obesity-related hormonal changes, overactivity of the RAAS, and inflammation.  Leptin is a hormone that is made up of adipose (fat) cells in the small intestine that regulates hunger and fat storage in the body. It sends signals to the brain of when to stop eating and tells the body how much energy should use. This hormone is tied with obesity, since it’s found in the adipose, the more fat a person adds to the body, the more leptin produced. With that much leptin in the blood stream can cause hypertension because the hormone is not properly communicating with the body on how to regulate fat and energy. (Leptin, 2018) Inflammation directly causes hypertension simply because inflammation causes vascular damage and abnormal central neural regulation (Dinh, 2014). Excessive inflammation can cause irreversible damage to the not only the heart but some proinflammatory mediators.  Like explained before the renin-angiotensin-aldosterone system (RAAS) is a system in the body that regulates cardiovascular and renal tasks. The overactivity of the RAAS causes the blood pressure to increase to dangerous levels, this affects elders and obese people and can be very dangerous to one’s life. (Ferrari, 2013) B. (n.d.). Control of Blood Pressure | Boundless Anatomy and Physiology. Lumen. Retrieved April 17, 2021, from https://courses.lumenlearning.com/boundless-ap/chapter/control-of-blood-pressure/ Dampney, R. (2002, April 1). Central Mechanisms Underlying Short‐ And Long‐Term Regulation Of The Cardiovascular System. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1440-1681.2002.03640.x Dinh, Q. N. (2014, July 20). Roles of Inflammation, Oxidative Stress, and Vascular Dysfunction in Hypertension. Hindawi. https://www.hindawi.com/journals/bmri/2014/406960/ Ferrari, R. (2013, November 1). RAAS inhibition and mortality in hypertension. PubMed. https://pubmed.ncbi.nlm.nih.gov/24689028/ Leptin. (2018, November 1). Hormone Health Network. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/leptin Peer 2 Week 4 Initial Response A human being can develop medical conditions that can be detrimental to the body. One of these conditions is called hypertension. Hypertension is defined as an increased systemic arterial pressure that remains consistently 140/90 (McCance & Huether, 2018). There are different types of hypertension a patient can experience. One type is primary or essential hypertension that has no known cause (McCance & Huether, 2018). The other two types of hypertension are called secondary and complicated hypertension. Secondary hypertension is typically caused by another condition such are kidney disease (McCance & Huether, 2018). Complicated hypertension is diagnosed after the patient has had a history of hypertension, but the condition is now causing damage to the systemic blood vessels (McCance & Huether, 2018). The pathophysiology of hypertension is correlated by changes in the cardiovascular system. Hypertension occurs when cardiac output and/or total peripheral resistance increase in the body (McCance & Huether, 2018). These changes can be related to several factors physiologic factors that occur within the body. With primary hypertension inflammation, insulin resistance, and mechanisms in the sympathetic nervous sytem (McCance & Huether, 2018). Hypertension can be managed in several ways. Diet, medication, and exercise have been shown to be effective in managing hypertension (Delavar et al., 2020). However, many people with hypertension have poor management of their condition. According to one article uncontrolled hypertension is typically a result of poor adherence to the medication regimen (Delavar et al., 2020). Primary Hypertension and the Sympathetic Nervous System Dysfunction in the sympathetic nervous system can cause an individual to have primary hypertension. The sympathetic nervous system plays a role in maintaining blood pressure and cardiac output within the body to ensure tissue perfusion (McCance & Huether, 2018). When there is a dysfunction in the sympathetic nervous sytem the body can increase the amount of catecholamines, which will cause an elevated heart rate and increased vasoconstriction of the vessels (McCance & Huether, 2018). These actions will then increase blood pressure. Primary Hypertension and Insulin Resistance Insulin resistance can also cause primary hypertension in patients. Insulin resistance can cause endothelial injury, which effects the renal functions (McCance & Huether, 2018). Injury to the renal system plays a large part in why the patient experiences hypertension. The hypertension is typically caused by the retention of water and salt that causes an increase in blood volume, which will cause an elevation of blood pressure (McCance & Huether, 2018). Primary Hypertension and Inflammation Finally, inflammation can also cause primary hypertension in an individual. When the body suffers an injury that results in endothelial injury or tissue ischemia the body release cytokines (McCance & Huether, 2018). When the cytokines are released it triggers a vascular response which decreases the release of vasodilators and increase the release of vasoconstrictors (McCance & Huether, 2018). Primary hypertension related to hypertension can be seen in individuals with chronic inflammation diseases like rheumatoid arthritis (McCance & Huether, 2018). References Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Education and Counseling, 103(2), 336–342. https://doi.org/10.1016/j.pec.2019.08.028 McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book: The biologic basis for disease in adults and children (8th ed.). Mosby

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