Hypertension HTN is the main risk factor for cardiovascular disease and stroke

Hypertension (HTN) is the main risk factor for cardiovascular disease and stroke (Babaee Beigi et al., 2014, p. 94), this is well known. The question is how can we improve this, how can we educate, prescribe and monitor those who cannot come to us as caregivers? Community programs can be the answer, even simple visits to the client I believe can be a big impact however cost is always an issue no matter where the location may be. This article showed us what a large impact a community-led program can have, a program where teaching, monitoring, and intervention is involved. How the efforts of community-led programs assist those who were already hypertensive to care for themselves with coaching and monitoring. In the long run, the cost was minimal compared to the costs of treating the major complications of hypertension including stroke and coronary vascular disease (CVD). This type of intervention cannot be the work of one it needs to be the work of many and while it was not done in the United States I think that this effort can have a major impact on those who have hypertension and those who now suffer from complications from hypertension. Hypertension rightfully continues to command our attention (Desai, 2018, p. 1) as I believe it should. Working in dialysis many of my patients are either hypertensive or diabetic with hypertension leading in the African American community who are financially and medically unstable in my specific community, their only insurance is Medicaid, and many do not qualify for Medicare. They have been hypertension for most of their lives and while they were taking their medications when they were able to get them, they were not aware of the importance of adhering and monitoring that should be done in association with taking the medications. Therefore, public health HTN interventions offer the promise of decreasing CVD across various populations at risk, particularly in the underserved and disadvantaged communities, which are disproportionately burdened by HTN and its effects (Ferdinand et al., 2012, p. 1). This is where I believe a community-led program would be of great service not only in my community but in so many across the globe. However, there are great challenges and hurdles to overcome one being cost, insurance, awareness of such programs and a general interest in having this type of service. This is where I believe as future nurse practitioners and individuals of faith, we can make an impact on lending ourselves to the community to increase awareness. In the past decade, there has been a shift away from the traditional medical model of healthcare delivery to a more personalized system in which individuals are encouraged to participate in health maintenance activities and for those with health problems to work collaboratively with their healthcare providers (Logan, 2014, p. 1034). Bringing this service to the community and working collaboratively with them can do many things including decreasing the risk of further disease progression and complications and bring awareness to the community and most importantly showing the community that there is an interest in them.

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