Essential hypertension is one of two major forms of hypertension that “tends to develop
gradually over many years”(Story, 2018, p. 109). Essential hypertension causes narrowing of the
arteries and puts a lot of pressure on them. This excessive pressure can cause damage to blood
vessels and organs. The heart must also work harder to pump blood throughout the body due to
the narrowing of the arteries. Due to this vasoconstriction, “renal blood flow decreases, resulting
in an inappropriate activation of the renin-angiotensin-aldosterone system”(Story, 2018, p. 107).
Possible problems that are associated with high diastolic pressure headaches, nosebleeds, and
many other typical symptoms associated with hypertension. People who suffer from high
diastolic pressure have “double the risk of cardiovascular complications, including heart attacks,
strokes or heart-related death, compared to normal-pressure adults” (Daley, 2018). A symptom of
hypertension can be vision loss and vision blurriness. This is caused by the vasoconstriction of
arteries and blood vessels in the eye. These arteries can rupture under such high pressure which
would cause the several arteriolar ruptures that Ms. J. is exhibiting. This narrowing causes a
decrease in the ability of retinal arteries to carry oxygenated blood to the retina. All of these
factors can lead to the ruptures and sclerosis happening in Ms. J.’s eyes, indicating a serious
hypertension problem that needs to be controlled.
Hypertension causes your arteries to narrow. This makes it harder for blood to travel
through the body. This in turn makes your heart work faster. “In order to cope with increased
demands, the heart thickens and becomes larger” (American Heart Association, 2016). This
means that the larger the heart gets, the more it has to work to get oxygen and nutrients
throughout the body. The heart still works when it thickens like this, but it becomes much less
efficient at its job. This is when a person starts to have heart failure, which is “a condition where
your heart is unable to provide enough blood to the body”(American Heart Association, 2016).
Signs of congestive heart failure can be shortness of breath and epistaxis. This symptom of being
dyspneic and the nosebleeds can both be caused by both hypertension and heart failure. When a
patient exhibits both of these symptoms with a previous diagnosis of essential hypertension, it
warrants a visit to the doctor as they are most likely in the early stages of heart failure. One type
of medications that are helpful in treating hypertension are ACE inhibitors like Captopril or
Moexipril. ACE stands for angiotensin converting enzyme.Angiotensin causes the blood vessels
in the body to narrow. This medication in turn being an ACE inhibitor works by decreasing “the
production of angiotensin and, in turn, that helps lower blood pressure” (Morelli, n.d.). Another
type of medication that can be used to treat hypertension are diuretics like Torsemide or
Bumetanide. Diuretics work by “increasing urination which reduces sodium and fluid in the
body” (Morelli, n.d.) This reduction of sodium and fluid in the body in turn lowers blood volume
which then causes a lower blood pressure.
Morelli, J. (n.d.). High Blood Pressure Medications List and Side Effects. Retrieved from
https://www.rxlist.com/high_blood_pressure_hypertension_medications/drugs-
condition.htm#what_is_high_blood_pressure_hypertension
American Heart Association. (2016, October 31). How High Blood Pressure Can Lead to Heart
Failure. Retrieved from https://www.heart.org/en/health-topics/high-blood-pressure/health-
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