The Non-Communicable Diseases - 1: Hypertension.pdf

Non-Communicable Diseases (NCDs) are chronic conditions that do not
result from
an
(acute) infectious process and hence
are
“not
communicable/transmissible.”

A disease that has a prolonged course, that does not resolve spontaneously,
and for which a complete cure is rarely achieved.

TYPES OF NCDS
 Chronic Diseases e.g. Hypertension, Diabetes etc.
 Neoplasms e.g. Cancer of the breast, cervix, lungs etc.
 Mental Disorders e.g. Substance abuse, Depression, Smoking, Stress etc.
 Genetic Disorders e.g. Sickle Cell Disorder, G6PD etc.
 Chronic Respiratory Disease e.g. COPD, Asthma etc.
 Chronic neurologic disorders e.g. Alzheimer’s, dementias etc.
 Arthritis/Musculoskeletal diseases
 Unintentional injuries e.g. Road Traffic & Industrial Accidents etc

1. 1
THE NON-COMMUNICABLE
DISEASES -1
COMMUNITY HEALTH NURSING II
(GNS 313)
ALAGBE OLUWATOSIN A.
COLLEGE OF NURSING SCIENCES, BUTH, OGBOMOSO,
OYO STATE, NIGERIA
HYPERTENSION

2. 2
DEFINITION
Non-CommunicableDiseases(NCDs)arechronicconditionsthatdonot
resultfroman(acute)infectiousprocessandhenceare“not
communicable/transmissible.”
Adiseasethathasaprolongedcourse,thatdoesnotresolvespontaneously,
andforwhichacompletecureisrarelyachieved.
CHARACTERISTICS OF NCDS
Looking at the above definitions, the characteristics of NCDs are:
Complex etiology (causes)
Multiple risk factors
Long latency period
Non-contagious origin (non-communicable)
Prolonged course of illness
Functional impairment or disability

3. 3
TYPES OF NCDS
Chronic Diseases e.g. Hypertension, Diabetes etc.
Neoplasms e.g. Cancer of the breast, cervix, lungs etc.
Mental Disorders e.g. Substance abuse, Depression, Smoking, Stress etc.
Genetic Disorders e.g. Sickle Cell Disorder, G6PD etc.
Chronic Respiratory Disease e.g. COPD, Asthma etc.
Chronic neurologic disorders e.g. Alzheimer’s, dementiasetc.
Arthritis/Musculoskeletal diseases
Unintentional injuries e.g. Road Traffic & Industrial Accidents etc.

4. “An aspect of personal behavior or lifestyle, an environmental exposure, or a
hereditary characteristic that is associated with an increase in the occurrence of
a particular disease, injury, or other health conditions.”
Modifiable Risk Factors
A behavioral risk factor that canbe reduced or controlled by intervention,
thereby reducing the probability of disease.
WHO has prioritized the following:
Physical inactivity,
Tobacco use,
Alcohol use, and
Unhealthy diets (increased fat and sodium, with low fruit and vegetable intake)
Air Pollution
4
RISK FACTORS

5. 5
Non-Modifiable Risk Factors
A risk factor that cannot be reduced or controlled by intervention; for
example:
Age,
Gender,
Race, and
Family history (genetics).

6. 6
Metabolic Risk Factors
“Metabolic" refers to the biochemical processes involved in the body's normal
functioning
Behaviors (modifiable risk factors) can lead to metabolic/physiologic
changes.
WHO has prioritized the following four metabolic risk factors:
Raised blood pressure
Raised total cholesterol
Elevated glucose
Overweight/obesity
Environmental risk factors
SeveralenvironmentalriskfactorscontributetoNCDs.Airpollutionisthe
largestofthese,accountingfor6.7milliondeathsglobally.

7. 7
EPIDEMIOLOGY OF NCDS
NCDsalreadydisproportionatelyaffectlowandmiddle-incomecountries
wherenearly80%ofNCDdeaths(29million)occurannually.Theyarethe
leadingcausesofdeathinallregionsexceptAfricabutcurrentprojections
indicatedthattheyear2020hadthelargestincreaseinNCDdeath.
InAfricanations,deathsfromotherNCDsareprojectedtoexceedthe
combineddeathsofcommunicableandnutritionaldiseases&maternaland
perinataldeathsasthemostcommoncausesofdeathby2030.

8. 8
SOCIOECONOMIC IMPACTS OF NCDS
Poverty:TherapidriseinNCDsispredictedtoimpede“PovertyReduction
Initiatives”inlow-incomecountriesparticularlybyforcinguphouseholdcosts
associatedwithhealthcare.
IncreasedMortalityRate:Vulnerableandsociallydisadvantagedpeople
usuallygetsickeranddiesoonerthanpeoplewithhighersocialpositions
especiallybecausetheyareatgreaterriskofbeingexposedtoharmful
productssuchastobaccoandunhealthyfoodandhavelimitedaccesstohealth
services.Thisthereforereducetheworkforceandsubsequentlyaffectthe
economy
IncreasedMorbidityRate:PresenceofNCDsleadstosickmembersofthe
familytobecomesickerandothermemberstobecomesickbecauseofits
effectonthefinancialstateofthefamily.
ReduceProductivity:Thesickindividualisunabletoworkeffectivelyand
efficiently(absenteeismandearlyretirement)therebyreducingthe
productivityatworkwhichmayeventuallyleadtodismissalfromworkandthen
worseningthepovertylevelofthefamily,communityandthenation.

9. 9
SOCIOECONOMIC IMPACTS OF NCDS….CONT’D.
IncreasedBurdenontheNation’sHealthcareSystem:Increasecasesof
NCDssubsequentlyincreasetherateatwhichpeoplepresentthemselvesin
thehospitalandthecostofhealthcareofthenation.
SocialIsolation:Non-communicableDiseasescanleadtosocialisolation,
stigma,anddiscrimination.
ImpactonEducation:NCDscanaffecteducationalattainmentand
opportunities,particularlyforchildrenandadolescents.
IntergenerationalImpact:NCDscanaffectfuturegenerationsthrough
epigeneticchanges,familydynamics,andsocioeconomicstatus.

10. 10
THE LEADING
NON-COMMUNICABLE DISEASES

11. 11
HYPERTENSION

12. 12
HYPERTENSION
Thisisaconditioninwhichthebloodpressureoftheindividualishigherthan
normalforhis/heragegroup,sex,occupationetc.Foranaverageadult,
140/80mmHgisstillconsiderednormal.
Types of Hypertension
Primary/Essential:Highbloodpressurethatisnotrelatedtoanother
medicalconditionoranyidentifiablephysiologiccause
Secondary:Anothermedicalconditionthatcauseshighbloodpressure,
usuallyoccurringinthekidneys,arteries,heart,orendocrinesystem.
Examplesinclude:Sleepproblemslikesleepapnea,Blockedrenalarteries
inthekidneys,Unusuallevelsofhormonescontrollingbloodpressure,
HeartDiseasese.g.Coarctationoftheaorta,DiabetesMellitus,
Phaeochromocytomaetc.

13. 13
Stages of Hypertension
Normal: Below 120/80.
Elevated: 120 to 129/Less Than 80.
Stage 1 High Blood Pressure: 130 to 139/80 to 89.
Stage 2 High Blood Pressure: 140 and Above/90 and Above.
Hypertensive Crisis: Higher Than 180/Higher Than 120.
Signs&Symptoms
Mostpeoplewithhypertensiondon’tfeelanysymptoms.Veryhighblood
pressurescancauseheadaches,blurredvision,chestpainandother
symptoms.
Checkingyourbloodpressureisthebestwaytoknowifyouhavehighblood
pressure.Ifhypertensionisn’ttreated,itcancauseotherhealthconditions
likekidneydisease,heartdiseaseandstroke.

14. 14
Peoplewithveryhighbloodpressure(usually180/120orhigher)can
experiencesymptomsincluding:
severe headaches
chest pain
dizziness
difficulty breathing
nausea
vomiting
blurred vision or other vision changes
anxiety
confusion
buzzing in the ears
nosebleeds
abnormal heart rhythm

15. 15
Ifyouareexperiencinganyofthesesymptomsandahighbloodpressure,
seekcareimmediately.
Theonlywaytodetecthypertensionistohaveahealthprofessionalmeasure
thebloodpressure.Havingbloodpressuremeasuredisquickandpainless.
Althoughindividualscanmeasuretheirownbloodpressureusingautomated
devices,anevaluationbyahealthprofessionalisimportantforassessmentof
riskandassociatedconditions.

16. 16
Riskfactors
Obesity
Smoking
Excessiveconsumptionofalcohol
Stress
Lackofexercise
ExcessiveConsumptionofCholesterol-basedfoode.g.milk,egg,yolk,
butteretc.
Treatment
Lifestylechanges/modificationcanhelplowerhighbloodpressure.These
include:
eating a healthy, low-salt diet
losing weight
being physically active
quitting tobacco.

17. 17
Medications
Thereareseveralcommonbloodpressuremedicationsthatmaybe
prescribedifyourhavehypertension,theyinclude:
ACEinhibitors:EnalaprilandLisinoprilrelaxbloodvesselsandprevent
kidneydamage.
Angiotensin-2receptorblockers(ARBs):LosartanandTelmisartanrelax
bloodvesselsandpreventkidneydamage.
Calciumchannelblockers:AmlodipineandFelodipinerelaxbloodvessels.
Diuretics:Hydrochlorothiazide(HCT)andChlorthalidoneeliminateextra
waterfromthebody,loweringbloodpressure.
ETC.
Lifestylechangescanhelplowerhighbloodpressureandcanhelp
anyonewithhypertension.Manywhomakethesechangeswillstill
needtotakemedicine.

18. 18
Prevention
Theselifestylechangescanhelppreventandlowerhighbloodpressure.
Do:
Eatmorevegetablesandfruits.
Sitless.
Bemorephysicallyactive,whichcanincludewalking,running,swimming,
dancingoractivitiesthatbuildstrength,likeliftingweights.
Loseweightifyou’reoverweightorobese.
Takemedicinesasprescribedbyyourhealthcareprofessional.
Keepappointmentswithyourhealthcareprofessional.
Don’t:
eattoomuchsaltyfood
eatfoodshighinsaturatedortransfats
smokeorusetobacco
drinktoomuchalcohol
missorsharemedication.

19. 19
StepsinmonitoringclientswithHypertension
Routineexaminationofurineforproteinandsugar
Regularcheckingofweight,bloodpressure,cholesterolleveletc.
Complicationsofuncontrolledhypertension
Chest Pain -also called angina;
Heart Attack -which occurs when the blood supply to the heart is blocked and heart muscle
cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to
the heart;
Heart Failure -which occurs when the heart cannot pump enough blood and oxygen to other
vital body organs; and
Irregular Heart Beat -which can lead to a sudden death.

20. 20