Identification of the Patient/Family/Population Health Problem Relevant to My Practice Summary of the Health Problem

Chronic illness management places a significant burden on patients and the healthcare system as a whole. A significant proportion of the global population is affected by hypertension, chronic disease, and the leading preventable risk factor for cardiovascular disease (CVD). Hypertension is defined as high blood pressure, with a systolic blood pressure of ≥140 mm Hg and a diastolic blood pressure of ≥90 mm Hg (AHA, 2022). Also, Mills et al. (2020) define hypertension as the current use of antihypertensive medications for research purposes. In 2010, the condition affected 1.38 billion people, or 31.1% of the global population, with men having a slightly higher prevalence of 31.9% than females, who had a prevalence of 30.1% (Mills et al., 2020). 

Modifiable risk factors for hypertension include obesity, alcohol, smoking, diet, and physical inactivity. In contrast, the non-modifiable risk factors include a family history of hypertension, age over 65, and comorbidities such as chronic kidney disease [CKD] (World Health Organization, WHO, 2021). Since hypertension is mostly asymptomatic, most people are unaware they have it, earning it the moniker “silent killer.” If symptoms exist, they are often nonspecific and may include headaches, fatigue, nosebleeds, irregular heartbeats, vision changes, and ear buzzing (WHO, 2022). Because of the serious damage that hypertension causes to essential body organs such as the kidney, heart, eyes, brain, and so on, it is recommended that the problem be identified and treated as soon as possible to avoid rapid progression to unwanted sequela.

Patient/Family/Group that I intend to work with

I plan to work with adult hypertensive patients during my practicum. Patients with a systolic blood pressure of 140 mm Hg and a diastolic blood pressure of 90 mm Hg, or those who are currently taking hypertensive medications, fall into this category. According to WHO (2021), an estimated 1.28 billion adults aged 30-79 worldwide have hypertension, with two-thirds of them living in low-to-middle-income countries.

Approximately 46% of adults with hypertension are unaware of their condition, and approximately 42% are diagnosed and treated (WHO, 2021). Furthermore, it is estimated that only one in every five adults (21%) has hypertension under control. As a result, while efforts to control hypertension have long existed, more efforts are still required to meet the global target of a 33% reduction in hypertension prevalence between 2010 and 2030 (WHO, 2021). Adult hypertensive patients would be a potentially valuable population for my practicum.

Significance and Relevance of the Problem

Hypertension contributes significantly to the global burden of CVD and premature death. In 2015, there were approximately 10.7 million all-cause deaths associated with a systolic blood pressure of ≥110-115 mm Hg (19.2% of all deaths) and 7.8 million (14% of all deaths) all-cause deaths associated with a systolic blood pressure of ≥140 mm Hg (Mills et al., 2020). Various CVDs were responsible for these deaths, including ischemic heart disease (IHD), ischemic stroke, and hemorrhagic stroke. In addition to CVD events, several studies have shown that hypertension is a significant independent risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). 

In one study, 332544 men aged 35-57 years who were screened for entry into the MRFIT trial and did not have ESRD at baseline were followed for 16 years, and when compared to normotensive men with a systolic blood pressure of <120 mm Hg and diastolic blood pressure of <80 mm Hg, the findings revealed that the relative risk of ESRD for men with hypertension who had a systolic BP >210 mmHg or diastolic BP >120 mmHg was 22.1 [P < 0.001] (Mills et al., 2020).

Additionally, individuals with hypertension in the United States (US) are estimated to have nearly $ 2,000 higher annual healthcare expenditures than their non-hypertensive peers, and hypertension is associated with approximately $131 billion in healthcare costs (Kirkland et al., 2018). With the obvious burden of hyperten