Evaluation Hypertension Clinical Practice Guideline

1.      Healthcare Problem

i.                    Description of Hypertension

Hypertension is characterized by insistently high blood pressure (BP) in a patient’s systemic arteries (Oparil et al., 2018). Majorly, blood pressure is expressed as the ratio of systolic blood pressure and diastolic blood pressure. The threshold of BP that defines hypertension depends on the measurement method used including Office BP, Ambulatory BP, and Home BP among other relevant measurement techniques. Various etiologies potentially underlie the disease. For example, the majority of hypertension patients are characterized by a highly heterogeneous primary hypertension comprising of a multi-factorial gene-environment etiology (Taddei et al., 2018). Besides, the frequent occurrence of the disease is also linked to a positive family history of hypertension. Ideally, research studies have estimated the heritability of the disease to range between 35% and 50% (Oparil et al., 2018). The condition is regarded as among the most common preventable cardiovascular disease risk factor (Oparil et al., 2018; Taddei et al., 2018). The morbidity data from the Centers for Disease Control and Prevention (CDC) provides that 49.6% of US adults aged 20 years and older had hypertension in 2017-2018 while approximately 36,524 individuals died from the condition; providing an estimated 11.1 deaths per 100,000 people died from essential hypertension and hypertensive disease (CDC, 2021).

ii.                  Epidemiology of Hypertension

The definition of hypertension varies depending on guidelines, for instance, Whelton et al. (2018) note that the American guidelines provide the threshold for the diagnosis of the disease to values of at least 80 mmHg for diastolic blood pressure and values of at least 130 mmHg for systolic blood pressure (130/80 mmHg). On the contrary, the 2018 European guideline on hypertension recommended a threshold of 140/90 mmHg (Taddei et al., 2018). Data provides that hypertension-related deaths occur due to ischemic heart disease, ischemic stroke, and hemorrhagic stroke, which according to estimates account for 4.9 million, 1.5 million, and 2 million deaths in that order (Forouzanfar et al., 2017).