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Hypertension Management and Control

Meire Louzada

School of Nursing and Health Sciences, Capella University

NURSE-FPX 4900

Instructor’s Name

August, 2021
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Hypertension Management and Control

Effects of Hypertension on Quality of Care

Hypertension affects the quality of care, patient safety and the financial status of an

individuals and the whole healthcare system. High blood pressure affects approximately 110

million adults in the U.S. Out of this population, nearly 70% have a law quality of life (Shrestha

et al., 2018). These low living standards are primarily a result of suboptimal care that patients

receive. Impediments or barriers that make hypertension patients to receive low quality care have

been categorized into patient, healthcare provider and healthcare system barriers. Patient barriers

include aspects such as lack of sufficient knowledge, motivation or financial ability to receive

high quality hypertension care (Shrestha et al., 2018). Healthcare provider barriers include

aspects such as insufficient knowledge or skills on how to manage particular patient populations

such as the elderly (Shrestha et al., 2018). Healthcare providers also find it challenging to adopt

new clinical information and practice guidelines thus limiting the quality of patient care they

deliver to hypertension patients.

Meanwhile, healthcare system barriers include factors such lack of enough healthcare

resources such as time facilities to cater to hypertension patients. These barriers have

significantly contributed to the reduced quality of care for hypertension patients. In this regard,

improving the quality of care for high blood pressure patients will involve educating all the

public and all hypertension patients on how to manage hypertension through lifestyle

modification and adherence to clinical guidelines (Buawangpong et al., 2020). Government

funding to facilitate establishment various facilities to support hypertension care could also be an

ideal way of improving the quality of care for hypertension patients.

Effects of Hypertension on Patient Safety

Hypertension also affects patient safety. Studies have found out that high blood pressure

can damage important body organs such as the heart, lungs, kidneys and eyes. Hypertension

damages arteries by decreasing their elasticity thus limiting the blood flow to the heart leading to

heart disease (Mayo Clinic, 2021). Decreased blood flow to the heart can also cause chest pain,

heart attack and heart failure (Mayo Clinic, 2021). Heart attack occurs when blood supply to the

heart is blocked and the heart muscles die due to insufficient oxygen (Mayo Clinic, 2021). On

the other hand, heart failure occurs when the heart cannot pump enough blood to other body

organs (Mayo Clinic, 2021). High blood pressure could also lead to the bursting of blood

arteries, a condition known as stroke. Stroke results in further disabilities in movement and speec

(Mayo Clinic, 2021)h. This condition can also result in death in extreme cases (Mayo Clinic,

2021). Hypertension is also linked to kidney disease and cognitive dysfunction (Mayo Clinic,

2021). Overall, high blood pressure does not only affect patients’ health status but also exposes

them to other serious health conditions such as heart disease and stroke. These condition threaten

patient safety.

Several factors, including ineffective communication, lack of enough multidisciplinary

collaboration and inadequate patient education affect patient safety. Ineffective communication

and multidisciplinary collaboration can lead to serious medical errors and incomplete follows ups

that threaten patient safety (Wu & Busch, 2019). Additionally, ineffective communication

between a healthcare provider and a nurse could lead to non-adherence to treatment plans which

increases the patient’s risks to acquiring more long term complications (Wu & Busch, 2019).

Meanwhile, lack of enough patient education on hypertension also limits the patient’s ability to

control the condition thus increasing the patient’s risk to other conditions such as heart failure,

heart attack and even death. Based on these risk factors, ideal methods to improve patient safety
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for high blood pressure patients include enhancing regular communication and engagement

between patients and their caregivers. Regular contact between patients and caregivers increases

patients’ adherence to treatment plans and optimizes their healthcare outcomes (Wu & Busch,

2019). Another method to improve patient safety is by embracing patient centered care and

evidence based practices (Wu & Busch, 2019). Research has proven that patient centered care

and evidence based practices reduce cost of care, improve patient safety and enhance positive

healthcare outcomes.

Effects of Hypertension on Healthcare Costs

High blood pressure also affects financial status of the victim and the whole nation.

Individuals suffering from hypertension incur approximately $ 131 billion more than those

without hypertension (Kirkland et al., 2018). According to Kirkland et al. (2018) hypertension

patients spend an annual average of $ 2800 for outpatient care, $ 2,700 for inpatient care, $ 300

for emergency visits and $ 2,400 for medical prescriptions. These expenditures total to an annual

average of approximately $ 10,000 while individuals without hypertension spend approximately

$ 4000 annually (Kirkland et al., 2018). Several measures have been developed to lower the

above costs. The American Heart Association (AHA) developed four strategies that could help in

reducing the above costs. The first strategy is early intervention aimed at lowering the number of

high blood pressure patients and long term costs associated with the disease (Otto et al., 2021).

The second strategy is maintaining patients’ blood pressure in the ‘healthy zone.’ This strategy

involves continually monitoring patient’s blood pressure constant clinical visits and regular

communication between patients’ and their caregiver (Otto et al., 2021). The third strategy is

increasing multidisciplinary collaboration to reduce medical errors and enhance treatment

outcomes (Otto et al., 2021). The last strategy to reduce healthcare costs associated with
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hypertension management is improving the accessibility to quality care, providing enough social

support and education to patients and the general public (Otto et al., 2021). Education regarding

modification of lifestyles and adherence to treatment plans helps improve hypertension

management this reducing long term costs associated with the disease.

Effects of Government Policies on the Management of Hypertension

One of the government policies that has affected control and management of high blood pressure

is the Affordable Care Act (ACA). The former U.S president Barrack Obama signed ACA into

las in 2010 (Courtemanche et al., 2018). This law immediately resulted in reduced healthcare

costs increased healthcare coverage for individuals who could not afford private health insurance

(Courtemanche et al., 2018). ACA has improved hypertension management by extending

medical insurance cover to vulnerable individuals who could not afford private insurance. ACA

resulted in an increase in the number of people receiving hypertension management services

such as routine blood pressure checks and antihypertensive medication. Overall, ACA has

improved hypertension management by allowing diagnoses and treatment at reduced or no cost.

This aspect has made more patients be willing to report their conditions and take timely

interventions. Courtemanche et al. (2018), estimate that 25 million more people will have

healthcare coverage by 2025. This increased coverage will further increase management and

control of hypertension
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References

Buawangpong, N., Pinyopornpanish, K., Jiraporncharoen, W., Dejkriengkraikul, N.,

Sagulkoo, P., Pateekhum, C., & Angkurawaranon, C. (2020). Incorporating the

patient-centered approach into clinical practice helps improve quality of care in cases

of hypertension: A retrospective cohort study. BMC Family Practice, 21(1).

https://doi.org/10.1186/s12875-020-01183-0

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the

Affordable Care Act on health care access and self-assessed health after 3 years.

INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55,

004695801879636. https://doi.org/10.1177/0046958018796361

Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N.,

Mauldin, P. D., & Moran, W. P. (2018). Trends in healthcare expenditures among US

adults with hypertension: National estimates, 2003–2014. Journal of the American

Heart Association, 7(11). https://doi.org/10.1161/jaha.118.008731

Mayo Clinic. (2021, January 16). High blood pressure (hypertension) - Symptoms and

causes. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/

symptoms-causes/syc-20373410

Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F.,

Jneid, H., Krieger, E. V., Mack, M., McLeod, C., O’Gara, P. T., Rigolin, V. H.,

Sundt, T. M., Thompson, A., & Toly, C. (2021). 2020 ACC/AHA guideline for the

management of patients with valvular heart disease. Journal of the American College

of Cardiology, 77(4), e25-e197. https://doi.org/10.1016/j.jacc.2020.11.018

Shrestha, S., Shrestha, A., Koju, R. P., LoGerfo, J. P., Karmacharya, B. M., Sotoodehnia, N.,

& Fitzpatrick, A. L. (2018). Barriers and facilitators to treatment among patients with
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newly diagnosed hypertension in Nepal. Heart Asia, 10(2), e011047.

https://doi.org/10.1136/heartasia-2018-011047
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