Hypertension is most prevalent among older adults, with some studies indicating that the lifetime risk of developing hypertension is as high as 90% for people age 55-65. Yet, while it causes more than 7.0 million premature deaths annually, hypertension has been called “a neglected disease.”
A 2010 report from the Institute of Medicine called attention to a troubling paradox: “Although hypertension is relatively easy to prevent, simple to diagnose, and relatively inexpensive to treat, it remains the second leading cause of death among Americans.” Many of them age 65+.
Hypertension-related complexities have been revealed by research, and the actions needed to reduce risks are equally clear. This article identifies ways in which home health care can play a central role in managing hypertension risk for older people.
Investigating the old age-hypertension connection
A recent American College of Cardiology report (2020) stated that 70%+ of adults age 65+ have hypertension.
However, “despite having the highest prevalence of hypertension and greatest risk for [cardiovascular] morbidity and mortality, older adults are frequently undertreated for elevated blood pressure (BP),” the report stated, adding that this segment has been “traditionally excluded or underrepresented in clinical trials” for many reasons, including frailty, risk of falls, and cognitive impairment.
There are many connections in the dynamic between advancing age and hypertension, including age-related arterial stiffening, vascular health and inflammation, kidney disease, and sleep apnea.
In addition to these complexities, a simple fact remains: People age 65+ with hypertension are disproportionately burdened by the condition statistically, and often underserved by the healthcare system clinically.
Hypertension patients and co-morbidities
Coronary Heart Disease
3 essential home care contributions for hypertension
1. BLOOD PRESSURE MONITORING
“Blood-pressure age-related alterations are powerful determinants of major cardiovascular disease (CVD) events and mortality,” claimed The American Heart Association in a 2019 Circulation Research article. The article also pointed out that elevated systolic BP and lower diastolic BP in older people, when monitored and tracked effectively, can predict arterial stiffness and warn of future complications.
To this point, SeniorBridge Clinical Manager Angela Long added, “It’s important not to look only at numbers,” she said. “It’s not just about 120 over 80. It’s about trends. So we always start with vital signs, and then we chart the overall changes we see, because every patient is different.”
Increased BP control with augmented intervention
2. PHARMACOLOGIC AND NON-PHARMACOLOGIC INTERVENTIONS
Medication management – organization, storage, administration, record-keeping, identifying side effects, reporting changes, and more - is a core function of home healthcare. In addition, monitoring of lifestyle factors – as reported in a 2019 Clinical Cardiology study - play a powerful role in care for hypertension. Among them:
- Weight control
- Physical activity
- Sodium intake
- Alcohol intake
- Stress reduction
- Smoking cessation
- Behavioral therapies
Qualified home care services can play an influential role in keeping hypertension patients on track with healthy living practices.
For the hypertension patient at home, there’s evidence that telemedicine can do far more than save a trip to the doctor’s office. If BP is monitored by a skilled home care professional, telemedicine can facilitate the process of transferring information from the home to the doctor’s office. It can also be a powerful education tool for the patient.
The integrated care management model by SeniorBridge
Home care services vary widely in the services they provide.
SeniorBridge offers an integrated care management practice model that involves two components:
- Clinical care (under the direction of an RNCM/Registered Nurse Care Manager) supported by a Social Worker and a team of caregivers, based on patient’s needs and
- A portfolio of home care services and geriatric care management in such areas as nutrition, caregiver education, benefit coordination, transportation, and coordination with discharge planners, physicians, pharmacy, home health agencies, and care managers.
NOTE: We have full COVID-19 safety protocols in place to keep clients, families and associates safe.
For more information on hypertension home care support services, contact SeniorBridge.
National Library of Medicine /NIH/Institute of Medicine (2010)
American College of Cardiology (2020)
Science Direct/Journal of the American Medical Directors Association (2014)
Springer/Journal of General Internal Medicine (2011)
Clinical Cardiology (2019)
American Heart Association Journals (2020)
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