Introduction
Hypertension is a major issue. It is difficult to diagnose but can have disastrous consequences, including those related to cardiovascular illnesses, eye damage, kidney disease, and so on (NIH, 2018). However, hypertension can be prevented because many of its risk factors are modifiable (Campbell & Niebylski, 2014; CDC, 2018). In particular, patients at risk of developing hypertension can alter their diet (Campbell & Niebylski, 2014; Daskalopoulou et al., 2015). J.M.D. reports that he does not eat healthy foods, but he has a few hypertension risk factors. As a result, the present paper will consider the topic of hypertension prevention with a focus on diets to develop a teaching plan for J.M.D.
Preventable Disease Overview
Hypertension tends not to have symptoms until its complications are identifiable, which is why blood pressure (BP) monitoring is the key to diagnosing hypertension early (CDC, 2018; NIH, 2018). In particular, BP equal to or above 140/90 means hypertension (NIH, 2018). Sometimes, headaches or vomiting can be indicative of hypertension, but no other symptoms or findings are used to identify it (CDC, 2018). Multiple risk factors exist for hypertension (Campbell & Niebylski, 2014). For J.M.D., unhealthy eating, lack of activity, and alcohol consumption are some of them. Diabetes is also a risk factor, as well as being overweight and having relatives with the condition (the father of J.M.D. was diagnosed with hypertension). Finally, J.M.D. reports having “slightly elevated” BP at times, which is also a warning sign (Campbell & Niebylski, 2014; NIH, 2018). J.M.D. is not diagnosed with pre-hypertension, but the information gathered from the Genetic Family History and Milestone 1 Assignment allows stating that the patient is at risk of hypertension.
Evidence-Based Intervention
One of the evidence-based interventions that are recommended for patients at risk of developing hypertension is a healthy diet (Campbell & Niebylski, 2014). Modern guidelines suggest limiting sodium, sugar, fat, and alcohol intake and focusing on fresh vegetables and fruits (Campbell & Niebylski, 2014; Daskalopoulou et al., 2015). A specific BP-improving diet that is shown to be very effective is the Dietary Approach to Stop Hypertension (DASH). A recent systematic review and meta-analysis of twenty trials (1917 participants) by Siervo et al. (2015) demonstrate that DASH results in statistically significant decreases in BP. The outcomes were especially prominent in patients with elevated BP that J.M.D. reports occasionally having. Thus, DASH is an evidence-based intervention suitable for J.M.D. The short-term goals will include learning about DASH and deciding to test it, modify it, or choose another option. Then, J.M.D. will have the objective of trying his diet for four weeks. The long-term objective will be to discover an appropriate diet and follow it to control BP.
Implementation: Teaching Plan
My methods will involve the empowerment and engagement of J.M.D. in decision-making, a personalized approach, and evidence-based recommendations. To teach J.M.D. to eat healthy foods, I will provide him with information about hypertension to show why it should be prevented. Apart from personally explaining the details, I would instruct J.M.D. to visit CDC (2018) and NIH (2018); they present pertinent information in an accessible way, and they are very reliable sources. As a second step, I would inform J.M.D. about his options, out of which DASH is a highly recommended one (Daskalopoulou et al., 2015). We will also consider the topic of Kosher food and its incorporation into DASH, and a consultation with a dietician will be in order.
After the choice of the diet is made, J.M.D. will attempt to follow it for a week, and we will meet to discuss his progress. Any specific concerns will be addressed; together with J.M.D., we will customize the experience. I will suggest trying a diet for a total of four weeks; however, if J.M.D. is dissatisfied with it, we will begin looking for another option in cooperation with J.M.D.’s dietician. After the four weeks’ trial, we will meet for a discussion of the outcomes of the diet. Eventually, a comfortable option will be found.
Evaluation
Several evaluation methods are required for the intervention to be successful. BP readings are the objective measure of determining the effectiveness of the diet, but it is also necessary to track J.M.D.’s adherence. To this end, I propose the use of a diary. J.M.D.’s general reported well-being and emotional state are also important; J.M.D. will share it during his visits. If the evaluation shows no change in BP despite proper adherence, the diet may be changed; also, additional interventions can be introduced because hypertension is prevented through a series of measures (Campbell & Niebylski, 2014). In the case of poor adherence, different methods of ensuring it will be provided depending on the causes of the outcomes. For instance, forgetfulness can be rectified with the help of notes and notifications or specific phone applications. If the diet causes distress, it will be changed.
Summary
The study of J.M.D.’s Health History indicates that he has several hypertension risk factors. Healthy diets are shown to help to normalize BP and lower elevated BP. A recent meta-analysis suggests that DASH is a high-quality diet. J.M.D. will be offered this diet with an opportunity to modify it after being educated on the importance of preventing hypertension. The diet will be trialed while J.M.D.’s BP, adherence, and emotional state will be evaluated. The teaching plan intends to provide J.M.D. with important information about his health and promote his ability to care about himself. The eventual goal is the improvement of patient outcomes with respect to BP and the prevention of hypertension. Thus, I will educate and empower the patient to strengthen his health.
References
Campbell, N., & Niebylski, M. (2014). Prevention and control of hypertension. Current Opinion in Cardiology, 29(4), 324-330. Web.
CDC. (2018). High blood pressure signs and symptoms. Web.
Daskalopoulou, S. S., Rabi, D. M., Zarnke, K. B., Dasgupta, K., Nerenberg, K., Cloutier, L.,… McKay, D. W. (2015). The 2015 Canadian hypertension education program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Canadian Journal of Cardiology, 31(5), 549-568. Web.
NIH. (2018). High blood pressure. Web.
Siervo, M., Lara, J., Chowdhury, S., Ashor, A., Oggioni, C., & Mathers, J. (2015). Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. British Journal of Nutrition, 113(1), 1-15. Web.