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ACKNOWLEDGEMENT First and foremost we offer our sincerest gratitude to our clinical instructor. The supervision and support that he gave truly help the progression and smoothness of this project. The cooperation is much indeed appreciated. Our grateful thanks also go to the people of Abulalas and the health workers who became part of our project and for their warm acceptance for us. Without them we are not able to reach this moment, for completing all those data. Doing this project makes us realized the value of working together as a team and as a new experience in working environment which challenges us every minute. The whole program really brought us together to appreciate the true value of friendship and respect of each other. Great deals appreciated go to the contribution of the faculty and staff of College of Nursing for giving us the opportunity to experience doing this. Lastly we offer our regards and blessing to all those who supported us in any aspect during the completion of this project.

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INTRODUCTION

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HEALTH TEACHING CONTENT Learning objective: After 30 minutes of health teaching, the community people of Purok 5 Brgy. Abulalas will be able to: 1. 2. 3. 4. 5. Define hypertension Identify the differences between the two common classifications of hypertension. Determine the different risk factors Identify the sign and symptoms of hypertension Enumerate the key areas for prevention of hypertension according to Department of Health (DOH).

Content: Understanding Blood Pressure Blood pressure is the pressure your blood exerts against your blood vessel walls as your heart pumps. Blood pressure rises with each heartbeat and falls when the heart relaxes between beats, but there is always a certain amount of pressure in the arteries. That blood pressure comes from two physical forces. The heart creates one force as it pumps blood into the arteries and through the circulatory system. The other force comes from the arteries resisting the blood flow. How is blood pressure measured? Blood pressure is measured with a blood pressure cuff and recorded as two numbers, for example, 120/80 mm Hg (millimeters of mercury). Blood pressure measurements are usually taken at the upper arm over the brachial artery. The top, larger number is called the systolic pressure. This measure the pressure generated when the heart contracts (pumps). It reflects the pressure of the blood against arterial walls. The bottom, smaller number is called the diastolic pressure. This reflects the pressure in the arteries while the heart is filling and resting between heartbeats.

The American Heart Association has recommended guidelines to define normal and high blood pressure. Normal blood pressure less than 120/80 Pre-hypertension 120-139/ 80-89 High blood pressure (stage 1) 140-159/90-99 High blood pressure (stage 2) higher than 160/100

Hypertension Description Hypertension or high blood pressure is defined as a sustained elevation in mean arterial pressure. It is not a single disease state but a disorder with many causes, a variety of symptoms, and a range of responses to therapy. Hypertension is also a major risk for the development of other CVDs like coronary heart disease and stroke. There are two classifications of hypertension. Primary Hypertension: has no definite cause. It is also called essential hypertension or idiopathic hypertension. About 90% of all hypertensive have primary hypertension. Secondary Hypertension: usually the result of some other primary dieases leading to hypertension ssuch as renal disease.

High Blood Pressure Causes

In 90% of people with hypertension, the cause of high blood pressure is not known and is referred to as primary or essential hypertension. While the specific cause is unknown, there are risk factors that can contribute to developing high blood pressure. Factors that cannot be changed: Age: The older a person is, the greater the likelihood that he or she will develop high blood pressure, especially elevated systolic readings. This is largely due to arteriosclerosis, or "hardening of the arteries." Race: African Americans develop high blood pressure more often than Caucasians. They develop high blood pressure at a younger age and develop more severe complications sooner in life. Socioeconomic status: High blood pressure is found more commonly among the less educated and lower socioeconomic groups. Residents of the southeastern United States, both Caucasian and African American, are more likely to have high blood pressure than residents of other regions. Family history (heredity): The tendency to have high blood pressure appears to run in families. Gender: Generally men have a greater likelihood of developing high blood pressure than women. This likelihood varies according to age and among various ethnic groups. Factors that can be changed Obesity: As body weight increases, the blood pressure rises. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m. A BMI of 25-30 kg/m is considered overweight (BMI=weight in pounds x 703/ height in inches ) Being overweight increases the risk of high blood pressure. Health care practitioners recommend that all obese people with high blood pressure lose weight until they are within 15% of their healthy body weight.

Obese people are two to six times more likely to develop high blood pressure than people whose weight is within a healthy range.

Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.

Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure increases if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 1015 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over-the-counter medicines also contain large amounts of sodium. Read food labels and learn about salt content in foods and other products as a healthy first step to reducing salt intake. Fast food restaurants also make the salt and calorie content of their food available to consumers at their restaurants, Alcohol use: Drinking more than one to two drinks of alcohol per day tends to raise blood pressure in those who are sensitive to alcohol. Birth control pills (oral contraceptive use): Some women who take birth control pills develop high blood pressure. Lack of exercise (physical inactivity): A sedentary lifestyle contributes to the development of obesity and high blood pressure. Medications: Certain drugs, such as amphetamines (stimulants), diet pills, and some medications used for cold and allergy symptoms such aspseudoephedrine, tend to raise blood pressure.

High Blood Pressure Symptoms High blood pressure usually causes no symptoms and high blood pressure often is labeled "the silent killer." People who have high blood pressure typically don't know it until their blood pressure is measured. Sometimes people with markedly elevated blood pressure may develop: headache, dizziness, blurred vision, nausea and vomiting, and Chest pain and shortness of breath.

People often do not seek medical care until they have symptoms arising from the organ damage caused by chronic (ongoing, long-term) high blood pressure. The following types of organ damage are commonly seen in chronic high blood pressure: Heart attack Heart failure Stroke or transient ischemic attack (TIA) Kidney failure Eye damage with progressive vision loss Peripheral arterial disease causing leg pain with walking (claudication) Outpouchings of the aorta, called aneurysms

About 1% of people with high blood pressure do not seek medical care until the high blood pressure is very severe, a condition known as malignant hypertension. In malignant hypertension, the diastolic blood pressure (the lower number) often exceeds 140 mm Hg. Malignant hypertension may be associated with headache, lightheadedness, nausea, vomiting, and stroke like symptoms

Malignant hypertension requires emergency intervention and lowering of blood pressure to prevent brain hemorrhage or stroke.

It is of utmost importance to realize that high blood pressure can be unrecognized for years, causing no symptoms but causing progressive damage to the heart, other organs, and blood vessels.

When to Seek Medical Care

Many symptoms present gradually after years of poorly blood pressure control. Many times, the first knowledge of hypertension occurs when a patient complains of chest pain or has stroke-like symptoms. You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care. There are non-specific symptoms associated with hypertension that may cause a person to seek care, including lightheadedness, dizziness, headache with or without nausea, change in vision, or lethargy and fatigue. There are many other reasons to develop these symptoms other than high blood pressure.

High Blood Pressure Diagnosis

Normal Blood Pressure o Systolic less than 120 mm Hg; diastolic less than 80 mm Hg

Prehypertension o Systolic 120-139 or diastolic 80-89 mm Hg High Blood Pressure o Stage 1: Systolic 140-159; diastolic 90-99 mm Hg o Stage 2: Systolic more than 160; diastolic more than 100 mm Hg

High Blood Pressure Medication

It may take trial and error to find the proper medication or combination of medications that will help control hypertension in each case. It is important to take the medications as prescribed and only discontinue them on the advice of your health care practitioner.

Water Pills (diuretics) Diuretics are used very widely to control mildly high blood pressure, and are often used in combination with other medications. They increase sodium excretion and urine output and decrease blood volume. The sensitivity to the effect of other hormones in your body is decreased. One example of a diuretic is hydrochlorothiazide (HydroDIURIL) The most commonly used diuretics to treat hypertension include: hydrochlorothiazide (HydroDIURIL), the loop diuretics furosemide (Lasix) and torsemide (Demadex), the combination of triamterene and hydrochlorothiazide (Dyazide), and metolazone (Zaroxolyn).

Key Areas for Prevention of Hypertension Encourage Proper Nutrition- Reduce salt and fat intake Prevent becoming overweight or obese weight reduction through proper nutrition and exercise Smoking Cessation- Tobacco use promotes atherosclerosis that may contribute to hypertension; quit smoking anytime is beneficial; this refers to both active and passive smokers. Identify people with risk factors and encourage regular check-ups for possible hypertension and modification of risk factors.

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