Hypertension or high blood pressure is a leading cause of morbidity and mortality in the United States affecting more than 874 million adults world-wide. Hypertension is a chronic health disease described as an increase in systolic or diastolic blood pressure greater than 139/89 that can begin with either a primary or secondary cause. Researchers theorize that primary hypertension may be caused by changes in the structure or function of the sensory nervous system and vasomotor system centers. Secondary causes include kidney disease and diabetes mellitus. Hypertension can affect any organ system leading to vision changes, myocardial infarction, cerebrovascular accident, kidney failure and erectile dysfunction.
Individuals with high blood pressure should focus on modifiable risk factors such as improving diet/nutrition, decreasing weight, tobacco cessation, reducing alcohol intake, increasing exercise, and addressing mental health concerns including stress, depression and anxiety. Best outcomes are achieved when all health concerns (physical and mental) are addressed utilizing the entire health team.
Behavioral health providers may assist an individual by utilizing techniques such as motivational interviewing (MI) and mindfulness- based stress reduction therapy (MBSR) to help guide patients into making lifestyle changes. MI is a useful technique in which providers help patients assess current behaviors and understand how their maladaptive behavior relates to their values and influences their goals. According to Ma, Zhou, Zhou, and Huang (2013), MI is a helpful way to increase patients’ self- advocacy in reducing their blood pressure and maintain treatment adherence. MI is a cost- effective method that is easily provided to patients in hospital or clinic settings.
Mindfulness-based stress reduction therapy is also a cost-effective method for addressing behavioral health concerns. MBSR has proven effective for adults battling stress, depression, and anxiety with chronic disease. In a meta-analysis conducted by Abbot et al., (2014), MBSR was proven to be effective for patients in reducing hypertension and improving overall mental health and quality of life.
Hypertension is a primary cause of death among adults worldwide. Providers should help patients focus on early identification and disease prevention. Treatment of the causes of hypertension center on interventions that influence modifiable risk factors. Motivational interviewing and Mindfulness- based stress reduction are cost-effective, proven interventions which should be considered for our patients with diabetes.