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WK6AssgnJewesimiO.pptxPrevention of Hypertension for African American Males in Douglasville Georgia
Oluwafunmilayo Jewesimi
Walden University
Dr. Catherine Chung
Nurs 4210 Role of the Nurse Leader in Population Health
July 8, 2020
Douglasville Georgia and Hypertension
Douglasville derived her name from a Skint Chestnut. (Douglasville Georgia, 2020).
Douglasville has an average population of about 30,961.
African American population of 17,297 and male population of 7,872 (The U.S Census Bureau, 2019).
Hypertension is common among the African American male in Douglasville.
Hypertension is a silent killer with many people asymptomatic.
Untreated hypertension damages the circulatory system, causes heart attack, stroke, and other health threats (AHA, 2017).
Hypertension is consistent high force pushing blood through the blood vessels (AHA, 2017).
Blood pressure is measured in mmHg unit.
Normal blood pressure is systolic of 120 and diastolic of 80 (AHA, 2017).
Elevated blood pressure has systolic between 120-129 and diastolic less than 80 (AHA, 2017).
Hypertension stage one is systolic between 130-139 and diastolic between 80-89 (AHA, 2017).
Hypertension stage 2 is systolic 140 or higher and diastolic 90, or higher (AHA, 2017).
Hypertensive crisis is systolic higher than 180 and diastolic higher than 120 (AHA, 2017).
What is Hypertension
Health determinants in this community includes social factors, health services, individual behavior, biology, and genetics (U.S. Department of Health and Human Services, 2016).
The social determinants of health, such as poverty, unemployment, education, access to health services, housing, exposure to crime, violence, living wages, neighborhoods, and healthy foods, all play a crucial role in preventing or managing illness (Stanhope & Lancaster, 2016).
Stressors faced are neighborhood life , lack of support, and knowledge deficiency of health condition.
Substance abuse is prevalent among this group.
African American males are at high risk based on food choice, culture, age, and low control rate of hypertension.
Blacks have a higher rate of hypertension. (Saeed et al., 2020).
Control rates and prevalence of blood pressure vary based on race/ethnicity.
Health determinants in Douglasville
Causes of Hypertension
Smoking, substance abuse and excessive alcohol consumption.
Unhealthy diet such as salty foods, fatty foods.
Obesity and Diabetes.
Sedentary lifestyle and delayed doctors' visits.
Knowledge deficiency and poverty.
Sleep apnea and stress.
High cholesterol (Mayo clinic, 2018).
Risk factors of hypertension
Africa-American Predisposition to Hypertension
Hypertension is developed early among African Americans (American Heart Association, 2016).
In United States boys and girls aged 8-17 years show greater systolic blood pressure of 2.9 mmHg and 1.6mmHg compared to white boys and girls (Lackland, 2014).
Over 40% of black men and women in the United States suffer from hypertension.
Its prevalence is the highest in the world (AHA, 2016).
American Heart Association known as CARDIA (Coronary Artery Risk Development in Young Adults) monitored the blood pressure of (3,890, ages 18 and 30) hypertension free and at baseline for 30 years (Cardiosmart, 2018).
African American Predisposition to Hypertension Contd.
CARDIA study revealed that 75% of blacks had developed hypertension by age 30 compared to 55% of white men and 40% of white women (Cardiosmart, 2018).
The Southern foods preparation are linked to hypertension and it involves frying, heavy cream use, and salty taste enhancers.
Due to cultural preferences for fat, salt, and pork, families and friends feel isolated when trying to comply with clinician-recommended diet (Petty et al., 2016).
Uncontrolled hypertension is increasing among African Americans with southerners at the highest risk (Petty et al., 2016).
Cultural Considerations and Genetic Predispositions
African American ethnic group remains the least healthy in United States due to years of racial, social injustice, and challenges in the health care (Noonan et al., 2016).
Report of health disparities endured by black and minority group was provided by Margaret Heckler in 1984.
The report eliminated disparities through health education, promotion and access to health care (Noonan et al., 2016).
After the elimination, there is still no power over policy and actions that will effect the needed change (Noonan et al., 2016).
Admixture mapping of genome-scan makers from African descent and European Americans revealed link to hypertension in Chromosome 6q24 and 21q21 (Zilbermint et al., 2019).
Complications of Hypertension
Heart attack or stroke.
Heart failure.
Weak and narrow blood vessels in the kidney.
Aneurysm.
Metabolic syndrome.
Trouble understanding or poor memory.
Dementia (Mayo clinic, 2018).
Evidence based behavior for health promotion
Avoiding unhealthy diet, tobacco use and physical inactivity is a health promotion for my community (CDC, 2020).
Nurses must continue to educate African Americans.
Implementation of Dietary Approach to Stop Hypertension (DASH) is crucial.
Fresh fruits, vegetables, whole grains, and lean proteins, has proven to help people with hypertension (Miller, 2017).
A measurable intervention for prevention of hypertension is weight loss.
1.2 kg weight loss can reduce systolic blood pressure by 3.8mmHg and 10kg loss will reduce systolic blood pressure by about 32mmHg (Maxwell, 2019).
Prevention of Hypertension
Choose a healthy eating plan and be physically active.
Regular doctor’s visit and wellness exam.
Don’t smoke and avoid secondhand smoke.
Make heart healthy living a family affair and know your family history.
Tame your stress and watch your weight.
Have your blood sugar checked.
Don’t brush off snoring (AHA, 2016).
Intervention based on the African American culture
Provision of easy to read educational materials that will bring awareness of this silent killer.
Providing incentives that will encourage seeking timely medical intervention that can promote preventive care.
Encouraging the presence of farmers market to allow easy access to fresh produce.
Providing vouchers to subsidize the cost of fresh produce.
Collaborating with the government to increase the presence of public health nurses and physicians in the community.
Providing more functional facilities that provide health promotion activities such as gymnasiums and sports classes.
Role of the health care leader
As a health care leader, educating my community about hypertension is a priority.
Collaborate with law-makers to address the health disparities in the community.
Collaborate with other health care providers to meet the health needs of my community.
Create more awareness about the dangers of delayed treatment.
Encourage the corner stores, grocery stores and farmers market to provide healthy foods at subsidized rates.
Encourage yearly check-ups and follow up visits to the physicians.
Involving parents of elementary and middle school African Americans to get involved in making healthy food choices for their children.
Feedback from my mentor and colleague
Mentor- Apart from the general intervention what other intervention would you include that will address the African American culture based on their social determinants?
Lynn-What intervention would you add to address the African American culture based on their food choices?
Mckenna- How can you make the government to get involved in addressing some of the health disparities in your community?
Lindsay-How would you encourage healthy food choices in the young African American male since they are affected by hypertension early in life?
Paula-How would you address shortage of healthcare providers in the community?
Note all feedback questions were addressed on slides 13 and 14.
References
American Heart Association (April1, 2016). How to Help Prevent Heart Disease At
Any Age. https://www.heart.org/en/healthy-living/healthy-lifestyle/how-to-
help-prevent-heart-disease-at-any-age
American Heart Association (2016). https://www.heart.org/en/health-topics/high-
blood-pressure/why-high-blood-pressure-is-a-silent-killer/high-blood-
pressure-and-african-americans
American Heart Association (October 31, 2016). High Blood Pressure and African
Americans: For African Americans, high blood pressure often develops early
in life. https://www.heart.org/en/health-topics/high-blood-pressure/why-high-
blood-pressure-is-a-silent-killer/high-blood-pressure-and-african-americans
American Heart Association (November 30, 2017). The Facts About High Blood
Pressure. https://www.heart.org/en/health-topics/high-blood-pressure/the-
facts-about-high-blood-pressure
References
Cardiosmart: American College of Cardiology (August 09, 2018). African
Americans are More Likely to Develop High Blood Pressure by Middle Age.
https://www.cardiosmart.org/News-and-Events/2018/08/African-Americans-
are-More-Likely-to-Develop-High-Blood-Pressure-by-Middle-Age
Centers for Disease Control and Prevention (February 24, 2020). Know Your Risk
for High Blood Pressure. https://www.cdc.gov/bloodpressure/risk_factors.htm
Lackland D. T. (2014). Racial differences in hypertension: implications for high
blood pressure management. The American journal of the medical sciences,
348(2), 135–138. https://doi.org/10.1097/MAJ.0000000000000308
Maxwell B. A. (May 25, 2019). The Roles of an Evidence-Based Weight
Management Protocol in Hypertension Control. University of San Diego.
https://doi.org/10.22371/07.2019.028
Mayo Clinic (May 12, 2018). High Blood Pressure (Hypertension).
https://www.mayoclinic.org/diseases-conditions/high-blood-
pressure/symptoms-causes/syc-20373410
References
Miller R. N. (May 5, 2017). Contributing News Writer. American Medical
Association. 4 ways to partner with black patients to control hypertension.
https://www.ama-assn.org/delivering-care/hypertension/4-ways-partner-black-
patients-control-hypertension
Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the
health of African Americans in the USA: an overdue opportunity for social
justice. Public health reviews, 37, 12. https://doi.org/10.1186/s40985-016-
0025-4
Pettey C. M., McSweeney J. C., Stewart K. E., Cleves M. A., Price E. T., Seongkum
H., Souder E. African Americans’ Perceptions of Adherence to Medications and
Lifestyle Changes Prescribed to Treat Hypertension. SAGE Journal. First
Published January 5, 2016. Research Article. https://journals.sagepub.com/doi/
full/10.1177/2158244015623595
References
Saeed A. MD, Dixon D. L. PharmD, FACC, Yang E. MD, FACC. (Apr 06, 2020).
Racial Disparities in Hypertension Prevalence and Management: A Crisis
Control? https://www.acc.org/latest-in-cardiology/articles/2020/04/06/08/53/
racial-disparities-in-hypertension-prevalence-and-management
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health
care in the community (9th ed.). St. Louis, MO: Elsevier.
U.S. Department of Health and Human Services. (2016a). Determinants of Health.
Retrieved Fromhttps://www.healthypeople.gov/2020/about/foundation-health-
measures/Determinants-of-Health
Zilbermint, M., Hannah-Shmouni, F., & Stratakis, C. A. (2019). Genetics of
Hypertension in African Americans and Others of African Descent.
International journal of molecular sciences, 20(5), 1081.
https://doi.org/10.3390/ijms20051081
