EFFECTIVENESS OF MANAGEMENT OF PATIENTS WITH HYPERTENSION IN SPECIALIST HOSPITAL JALINGO, TARABA STATE.

CHAPTER ONE

INTRODUCTION

1. Background of the Study

In general practice, hypertension presents itself rather often as a health problem. According to Akepalakorn (2020), there were over 11 million persons in Nigeria who had been diagnosed with hypertension, and data showed that there were over 600,000 new cases in the year 2012. (Tonghong, 2022). In the emergency department, patients with elevated blood pressure are classified as having "hypertensive emergency" if they were found to have progressive target organ damage, such as stroke, myocardial infarction, aortic dissection, or heart failure; "hypertensive urgency" if there were no severe symptoms or progressive end-organ damage found, and there was no prior history of hypertension recorded; and "uncontrolled severe hypertension" if they had a prior history of hypertension (Kaplan, 2016). There is currently no universally accepted criteria that can be used to assist in the identification of growing target organ damage in patients who present to the emergency room with high blood pressure. In one article, it was suggested to perform a fundoscopic examination, heart auscultation, abdominal examination, palpation of peripheral pulses, and comprehensive neurological examination, in addition to clinical laboratory testing of electrolytes, glucose, urea, creatinine, urine analysis, complete blood count, electrocardiogram, and chest radiography (Baumann, 2021). Nevertheless, given that these tests often fall within the normal range, the inquiry that is sent in these kinds of situations is mainly dependent on the judgment of the physician. It is still debatable whether or not persons who have been diagnosed with severe hypertension may successfully lower their blood pressure without further damaging their target organs. The American College of Emergency Physicians (ACEP) endorsed that asymptomatic high blood pressure now no longer be dealt with in theemergency department when patients were scheduled for follow-up care; however, if treatment was initiated, it was stressed that patients should not expect their blood pressure to be normal during the visit (Decker, 2019). Oral anti-hypertensive medications were presented as a therapy for severe hypertension without increasing the risk of injury to the target organs in the majority of published works. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 Report)(Chobanian et al, 2020) mentioned Clonidine, Labetalol, and Captopril. Other literatures mentioned Nifedipine, Lacidipine, Uradipil, Fenoldopam, Furosemide, Propranolol, and Losartan (Chobanian et al, 2020). Nevertheless, the most recent guidelines do not include any suggestions for treating severe hypertension in a way that would not further harm the target organs (James et al, 2018). A clinical practice guideline for the treatment of patients who have severe hypertension but do not have progressive damage to target organs has not yet been developed, and numerous studies are currently being conducted to evaluate the impact that oral anti-hypertensive medications have on patients with this condition. Therefore, the study will examine the effectiveness of management of patients with hypertension in specialist hospital Jalingo, Taraba state.

1. 1. Statement of the Problem

According to James et al. (2018), hypertensive heart disease, which is defined by the presence of left ventricular hypertrophy in the absence of any other cause other than arterial hypertension, has been considered for a very long time to be one of the most common aetiological conditions that predispose to heart failure. At the individual, institutional, social, and provider of health care levels in Nigeria, there are a number of obstacles that stand in the way of hypertension management. In spite of the continual development of antihypertensive techniques throughout the course of the years [Karras, 2017], there has been an apparent rise in the incidence of complications in patients who have hypertension. These obstacles are mostly responsible for this increase. According to [Karras, 2017], advances in medical science on the aetiopathophysiology of the illness have not been accompanied by corresponding advances in patient outcomes. Therefore, the study seeks to examine effectiveness of management of patients with hypertension in specialist hospital Jalingo, Taraba state.

1. 1. Objective of the Study

The broad objective of the study is to examine the effectiveness of management of patients with hypertension in specialist hospital Jalingo, Taraba state. The specific objectives is as follows:

1. To examine the factors responsible for hypertension among patient in specialist hospital Jalingo, Taraba state.

2. To investigate the effect of hypertension on patients in specialist hospital Jalingo, Taraba state.

3. To determine the approaches adopted for the management of hypertension among patients in specialist hospital Jalingo, Taraba state.

4. To find out the challenges in managing patients with hypertension in specialist hospital Jalingo, Taraba state.

1. 1. Research Questions

The following questions have been prepared for the study:

1. What are the factors responsible for hypertension among patient in specialist hospital Jalingo, Taraba state?

2. What is the effect of hypertension on patients in specialist hospital Jalingo, Taraba state?

3. What are the approaches adopted for the management of hypertension among patients in specialist hospital Jalingo, Taraba state?

4. What are the challenges in managing patients with hypertension in specialist hospital Jalingo, Taraba state?

1. 1. Significance of the Study

The study is significant to patients and health workers as decreasing the blood pressure and keeping it controlled, you are 25 percent less likely to die from cardiovascular disease. Spend a little money now and save a lot later. High blood pressure costs the nation nearly 50 billion dollars each year.

The study will be significant to the academic community as it will contribute to the existing literature.

1. 1. Scope of the Study

The scope of this study borders on the effectiveness of management of patients with hypertension in specialist hospital Jalingo, Taraba state. The study will examine the factors responsible for hypertension among patient in specialist hospital Jalingo, Taraba state. The study will also investigate the effect of hypertension on patients in specialist hospital Jalingo, Taraba state. The study will further find out the challenges in managing patients with hypertension in specialist hospital Jalingo, Taraba state.

The respondents for this study will be obtained among healthcare workers in specialist hospital Jalingo, Taraba state.

1. 1. Limitation of the Study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced.

1. 1. Definition of Terms