INTRODUCTION

Hypertension is generally defined as a systolic blood pressure greater than or equal to 135
mmHg and/or a diastolic blood pressure greater than or equal to 85 mmHg in individuals who do
not have diabetes. The new classification for “normal” adult blood pressure is less than 120 mmHg
systolic and less than 80 mmHg diastolic. Adults with blood pressure of 120 to 139 mmHg systolic
or 80-89 mmHg diastolic, considered “normal” under previous guidelines, are now classified as
prehypertensive and are in need of lifestyle changes to prevent cardiovascular complications. Other
classifications of hypertension are stage 1 hypertension which the systolic is 140-159 mmHg and
diastolic is 90-99 mmHg, and stage 2 hypertension which the systolic is more than 160 mmHg and
diastolic is more than 100 mmHg. Hypertension also called the silent killer because people who
have it are often symptom free.

The relationship between hypertension and cardiovascular events is direct and independent
of other risk factors. The higher the blood pressure, the greater the chance for coronary, cerebral,
renal and peripheral vascular disease. Control hypertension, however, has resulted in significant
decreases in cardiovascular morbidity and mortality. Hypertension often accompanies other risk
factors for atherosclerotic heart disease, such as dyslipidemia, obesity, diabetes, metabolic
syndrome, sedentary lifestyle, and obstructive sleep apnea. The prevalence is also higher in persons
who have other cardiovascular conditions, including heart failure, coronary artery disease, and a
history of stroke. Cigarette smoking does not cause high blood pressure; however, if a person with
hypertension smokes, his or her risk of dying of heart disease or related disorders increases
significantly. For hypertension to occur, there must be a change in one of more factors affecting
peripheral resistance or cardiac output. In addition, there must also be a problem with the body’s
control systems that monitor or regulate pressure. The tendency to develop hypertension is
inherited; however, genetic profiles alone cannot predict who will and will not develop
hypertension. In fact, researchers estimate that between individuals in 15% to 70% of cases. Many
causes of hypertension have been suggested to be, increased sympathetic nervous system activity
related dysfunction of the autoimmune nervous system, increased renal reabsorption of sodium,
chloride, and water related to genetic variation in the pathways by which the kidneys handle
sodium, increased the activity of renin-angiotensin-aldosterone system, resulting in expansion of
extracellular fluid volume and increased systemic vascular resistance, decreased vasodilation of
the arterioles related to the dysfunction of the vascular resistance, resistance to insulin action,
which may be a common factor linking to hypertension, type 2 DM, hypertriglyceridemia, obesity
and glucose intolerance, activation of the innate and adaptive components of the immune response
that may contribute to renal inflammation and dysfunctions.

The purpose of this case presentation is for us to discover the process of the problem
identified, how it is being acquired, clinical manifestation which some was being experienced by
our patient and how the environment and the condition of the family relates to the problem. By
doing so, we will be able to know the appropriate nursing care for our patient as well as the family.
This study will help us student to comprehend not only the disease mentioned but also for the
commonalities and differences among other diseases.