Hypertension in African American Elderly Males, Research Paper Example

Introduction

Hypertension, commonly called high blood pressure, is a very common condition. High blood pressure is more common in the African American ethnic group. According to the American Heart Association, black men aged 65 and older make up more than 40 percent of African Americans who have this disease. Accordingly, the prevalence of this disease is higher in African Americans than any other ethnic group. Not only are African Americans at higher risk of falling victim to hypertension, they often get it at a younger age than other ethnicities, and suffer from more dire complications. Hypertension is not just an adult disease, overweight preteens and teens are likely to develop high blood pressure like their adult counterparts. Hypertension has a significant impact on one’s health. It consists of major risk factors that can shorten one’s life by affecting the heart, blood vessels, kidneys, and lead to a heart attack or stroke. Fortunately, high blood pressure can be controlled and prevented through meticulous precautions. This paper attempts to shed light on the causes, effects, and symptoms of hypertension in African American males aged 65 years and older.

Target Population

Black men aged 65 and older are 64 percent more likely to develop hypertension than their other ethnic counterparts (Dressler 2006, pg. 73). Black men are a part of the ethnic group with the highest prevalence of hypertension in the world. Age 65 has traditionally been designated as the beginning of old age. This number was based solely on history and no other determinants in the past. Today, other factors affect a person’s overall retirement age, such as health. Hypertension can greatly affect a person health. Nonetheless, many people age 65 and older are still living productive lives. By age 65, most people have retired from their main job and settled into a less active life. They lose their daily routines and spend more time with friends, sleeping in, or doing hobbies that they enjoy. Some people in the age group move into assisted living facilities or closer to family members. Often these aged group people will sale their homes and move into smaller homes or apartments. The normal aging process consists of the decline in many bodily functions, such as: eye sight, mobility, strength, stamina, etc., but high blood pressure can increase these effects.

What is hypertension?

Blood pressure is the force or push of blood against the walls of ones arteries. A person’s blood pressure is determined by two factors: the amount of resistance ones arteries how forcefully the heart pumps the blood. Blood pressure is measured by two numbers-the systolic and diastolic pressure. The systolic pressure is the pressure against the arteries as the heart beats and the diastolic pressure is the pressure against the arteries as the heart relaxes. These are commonly referred to as the top and bottom numbers, respectively. Both numbers play an important role in determining a person’s blood pressure. A blood pressure reading of 120/80 is considered optimal by the National Heart, Lung, and Blood Institute. Blood pressure is considered to be in the high range if the systolic reading is 140 or the diastolic is at least 90. Risk factor such as, being overweight, lack of exercise, family history of hypertension, high sodium intake, too much alcohol consumption, and stress have been linked to onset of hypertension. Uncontrolled or untreated high blood pressure can lead to stroke, coronary artery disease and heart attack, kidney disorder, memory problems, dementia, impotence in men, and eventually death.

Warning signs and symptoms

It is a common misconception that people with high blood pressure will experience certain symptoms, but in fact hypertension is almost a symptomless disease. As a result, it is not wise to assume that if one has high blood pressure he/she will display certain symptoms. During the early 1990s it was believed that headaches were a common sign of high blood pressure. According to one study published by Wang, Staessen, Franklin, Fagard, & Gueyffier, people with high blood pressure actually have fewer headaches than persons with high blood pressure. According to them, people with high blood pressure are 40 percent less likely to have headaches as compared to people with normal blood pressure readings (2005, p. 909). Another misconception is that people who suffer from high blood pressure suffer from recurrent nosebleeds. It has been noted that people in the early stages of high blood pressure may have nose bleeds, but only 17 percent of people treated at hospitals for high blood pressure reportedly had nosebleeds (Wang, Staessen, Franklin, Fagard, & Gueyffier, p. 912). Consequently, there are many symptoms that may be indirectly linked to high blood pressure, but are not always clear indicators of the presence of high blood pressure, such as: blood spots in the eyes, facial flushing, dizziness, nausea, and blurred vision.

Diagnosis of Hypertension

Diagnosing high blood pressure can be tedious for health care providers because high blood pressure is almost symptomless. Many factors can temporarily raise blood pressure, such as: nervousness, anxiety, caffeinated beverages, alcoholic beverages, cigarettes, etc. As a result, one’s high blood pressure reading does not mean that one has high blood pressure. Health care providers will have a person with potential high blood pressure to come in at different times for several blood pressure tests, a physical exam, and to complete a medical history in order to determine if he/she has high blood pressure.

The Role of Health Care Providers

As health a care provider, one’s primary concern is advocating healthy lifestyles to all patients. African American patients are often victims to cultural eating patterns. Being that the patient is in the 65 or older age range, he has probably been eating according to his culture all of his life. For example, Cutler, Sorlie, Thom, Fields, & Roccell said “Black Americans men are more likely to have diabetes, high cholesterol, obesity, smoking issues, and high salt and fat in their diet — all risk factors for developing high blood pressure. In addition, they develop high blood pressure at younger ages than other ethnic groups in the United States and are more likely to have complications associated with high blood pressure, including stroke, kidney disease, blindness, dementia and heart disease”( 2008, p. 820 ). When working with him, a healthcare provider should implement more exercise and less sodium intake. A healthcare provider’s first assignment for him should be to have him complete a week long food diary and blood pressure readings. Next, he/she can sit down with him and discuss the healthy choices he made versus the not so healthy choices. A healthcare provider will probably suggest that he purchases his own personal blood pressure monitor, so that he can monitor his readings at home on a daily basis. Many members of this age group are reluctant to visit the doctor. According to Dressler, “Medical care use is generally lower among African Americans than among whites. Even among those who are aged 65 and older and have health insurance coverage through Medicare, African Americans receive fewer medical services than do whites. African American men, in particular, take fewer prescription and non-prescription medications than do their white counterparts” (2006, p. 79). He should also be encouraged to set a daily routine of exercise. At his age, no one would suggest that he starts weight lifting, but a daily walk in the park, or gardening, or may be an exercise bike would be a good way for him to get active. Hypertension can be a hereditary disease. The client can help implement healthier life choices for his younger family members by showing them the benefits he is reaping.

Age and Hypertension

Studies have conveyed that one’s likelihood of getting high blood pressure increases with age. Some changes that individuals go through after turning 65 could increase their chance of getting high blood pressure or increase its severity. When an individual retires at age 65, he or she will have to live on a fixed income. Living on a fixed income can alter the type and quantity of food he or she buys. Individuals with high blood pressure have to be mindful of the type of food they consume. Some foods, such as food high in sodium, can enhance high blood pressure issues. Social changes can affect blood pressure as well. People who are retired often become less active than they were when they were in the work force. Less activity can lead to weight gain, which is another factor that can enhance blood pressure issues. According to Appel, Brands, Daniels, Karanja, Elmer, & Sacks, 67 percent of black men aged 65 and older are overweight due to lack of exercise and the consumption of too many fatty and salty foods. Hypertension is directly linked to being overweight. They go on to convey that dieting and eating healthy is seen as characteristic of a woman, so they shy away from this to keep from being stereotyped. Also, many African American men refuse to take their hypertension medicines correctly out of fear of sexual dysfunctional. In their minds, not being able to perform sexually is a threat against their masculinity. All of these factors lead to uncontrolled cases of diabetes in black men aged 65 and older (2006, p. 305). Older people often experience psychological changes that can greatly affect their health. Some older people become forgetful or even develop dementia. This can be a problem for older adults who are controlling their hypertension with medication; they may forget to take their medicine. By age 65, biologically, the body is just unable to do the things it used to do. Black men in this age group often suffer from depression because they see the man they once knew declining. They often feel less of a man.

Available Resources

By age 65, some people are unable to live alone if they have severe hypertension and other health issues. For this population, family members may suggest having their loved one reside in an assisted living facility. Another possible option is to hire an on call nurse or professional sitter. This person can provide the loved one with the necessary help without requiring them to move out of their home. For example, Dressler said, “Traditionally, men are more likely to neglect their health compared with women, in part because of a belief that masculinity is associated with strength, independence, a reluctance to seek help, and denial of vulnerability” ( 2003, p. 75). Nurses and professional sitters can help the patient with cooking, cleaning, errands, and taking medication while the patient remains in his/her own home. Most importantly, they can provide the patient with companionship if they live alone. Many family members choose this option because of the fear of a loved one being abused or neglected in an in care facility. Some family members choose to have their loved one move in with them or they move in with the loved one. The main objective of the family members is to keep the loved one happy and as active as possible. There are some community services that can aid family members with the adjustment of their aging loved ones. Most communities have senior centers that function as a gathering place for the elderly who are still able to function as independent individuals. They usually provide social, cultural, and recreational activities for person 65 years and older. They may go on day trips, theaters, museums, provide opportunities for the seniors to volunteer places, provide hot meals, and health screening. Most communities provide these services free of charge to their seniors. Most of these centers even provide transportation to and from the center for those clients who no longer drive themselves. These services are important because they provide seniors with a daily routine and interaction with other people their age. The trips and routines also give caregivers and family members a much needed break from the tedious job of caring for an aging adult.

Conclusions

High blood pressure is more prominent in the African American culture than any other ethnic groups. Black men aged 65 and older are more likely to get high blood pressure. The key to saving black men from the effects of hypertension is education. Hypertension has been called the silent killer because there are often no symptoms are warning signs. Many men in this age range feel that if they don’t feel sick, they must be fine. Black men have to be educated so that they will lose their mistrust of doctors. The only sure way to know if one has high blood pressure is to be screened by a health care provider. Hypertension can be controlled through proper diet and exercise. In some cases, losing 10 pounds can lower ones blood pressure number between 2-8 points. Having family support is also important to older black men. For example, “Higher levels of social support of family and friends, including emotional, cognitive, and instrumental support, have been found to increase compliance with treatment among African Americans with chronic disease”( Welch 2003, p. 33 ). Older men have a desire to feel masculine, so they are very leery of asking for help from others. As a heath care provider, it is my duty to promote healthy living habits by educating my clients.

References

Appel, L.J. Brands, M.W., Daniels, S.R., Karanja, N., Elmer, P.J., & Sacks, F.M. (2006). Dietary approaches to prevent and treat hypertension. Hypertension 47, 296-308.

Cutler, J.A., Sorlie, P.D., Wolz, M., Thom, T., Fields, L.E., & Roccella, E.J. (2008). Trends in hypertension prevalence. Hypertension 52, 818-827.

Dressler, W.W. (2006). Hypertension in the african american community: social, cultural, and psychological factors. Psychosom Medical Journal 16, 71-82.

Wang, J.G., Staessen, J.A., Franklin, S.S., Fagard, R., & Gueyffier, F. (2005). Systolic and diastolic blood pressure lowering as determinants of cardiovascular outcome. Hypertension 45, 907-913.