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Hypertension in Australia

Hypertension in Australia

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Hypertension in Australia

Definition of Hypertension and Modifiable Risk Factors

As blood flows through the arteries, it puts pressure on the vessels' walls. As the heart pumps blood harder and the blood flow is much more complex, blood pressure rises resulting in high blood pressure also known as hypertension. On two different days, the diastolic and/or systolic blood pressure readings must be at least 90 mmHg in order to be diagnosed with hypertension (Stephen et al., 2019). Cardiovascular disease and stroke are two of the most common consequences that might result, as well as mortality (AIHW, 2016). Cardiovascular illness, including stroke, heart attack, heart failure, and aneurysm, are all linked to high blood pressure. It is essential to maintain good health and reduce the risk of these harmful illnesses if you keep your blood pressure in check. In most cases, high blood pressure comes on gradually. Modifiable risk factors are those risk factors that may be altered to assist prevent and control high blood pressure (Nguyen & Ding, 2019). It may be caused by a lack of regular physical exercise, a poor diet, excessive alcohol use, sleep apnea, stress, and cigarette use. High blood pressure may be exacerbated by a number of health issues, including diabetes and obesity. Pregnancy-related high blood pressure is also a possibility.

Hypertension in Australia

Around 16% of the population in Australia has high blood pressure that is not under control, which is a huge public health issue that has to be taken care of. High blood pressure was a prominent cause of mortality in Australia in 2015, accounting for 5.8% of all disease (AIHW 2016). Some studies point a high-salt diet as being responsible for about 21% of the burden of high blood pressure in Australia (AIHW 2018). High blood pressure was found in more than a third of persons aged 18 and above in the 2017–18 National Health Survey (2018). The World Health Organization (WHO) statistics show 18 % men and 12% women aged at least 18 had uncontrolled high blood pressure in Australia in 2015 (Hird et al., 2019). The percentages are higher than that of countries such as Republic of Korea (14 percent) followed by the United States of America (15%) and then Canada (10% although lower than Lithuania, Latvia, Hungary, and Slovenia which average 36% for men and between 23%-25% for women. Hypertension has thus put millions of Australians at risk of many diseases and is responsible for more fatalities in Australia than any other single risk factor (Ademi et al., 2021).

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Health Literacy and Hypertension

Health literacy is person's capacity to access, interpret, and apply health information on policies, procedures, and resources pertaining to the health care system and impact on how people interact. Increasing people's health literacy is one of the most critical techniques for fostering a healthy lifestyle. Health literacy encompasses the capacity to get, grasp, examine and draw conclusions, and convey information as a means of promoting, maintaining, and improving health in a variety of contexts (Gaffari-Fam et al., 2020). World Health Organization (WHO) encourage countries to monitor progress, facilitate collaboration and coordination between organizations and set policies for improving health literacy (Hird et al., 2019). Health outcomes and harmful habits have been linked to a lower level of HL in studies. Blood pressure management, understanding blood pressure measures, risk factors, and consequences as well as essential lifestyle adjustments are all variables that may be improved with the help of high blood pressure (Stephen et al., 2019). Information concerning one's health and the health of one's family appears to be more important to people who seek it out. One in every six adults in Australia has inadequate knowledge on how to make informed health care choices because of the country's poor health literacy rate. People with inadequate health literacy are more likely to utilize health care services, have less information about their own health, and have lower results (Betts et al, 2020). In terms of bad outcomes, it's been predicted that those with inadequate personal health literacy are between 1.5 and 3 times more probable.

Hypertension in Rural Australia

Australian Institute of Health and Welfare, 2017/18 (2019) indicate that at least 1/4 of men and 1/5 of women in rural Australia experience uncontrolled high blood pressure and among the elderly, hypertension is a common illness that goes undiagnosed and untreated. The reason could be that people in rural areas have a worse quality of life, lower educational and employment opportunities as well as a lack of access to healthcare services (Mitsuyama & Eto, 2018). More individuals were admitted to hospitals and died or were injured in remote areas than in big cities because of the reduced availability and use of basic healthcare in such areas, according to the statistics. Rural patients had a considerably longer follow-up period (72 +/-13 and 36 +/-5 days, respectively, P 0.01) than their urban counterparts. 90% of patients with hypertension were seen by urban primary care physicians, whereas only 9% of patients were treated by rural primary care doctors (86%). Ninety-five percent of rural and urban physicians wanted to maintain their diastolic pressure under 90 mmHg, while only 77 percent of rural and urban doctors wanted to keep their systolic pressure under 140 mmHg (P=0.06) (AIHW 2017/18, 2019). In terms of hypertension, no differences were found between rural and urban participants, as almost half of the participants were taking antihypertensive medication, while just a quarter of the urban participants were doing so. According to a research by Head et al (2019), out-of-office BP testing are crucial in diagnosing and treating hypertension.

Nurse Directed Health Promotion Intervention

  1. This study’s primary goal sought to evaluate a nursing intervention to decrease blood pressure in patients with high blood pressure and a severe cardiovascular risk, with the secondary purpose of assessing treatment's effect on lifestyle risk factors. 
  2. Patients at 45-74 years with hypertension who are at significant risk of a cardiovascular illness having visited participating GPs at least thrice in the previous two years are eligible into this program. Patients with English proficiency and mental competence will be included. An explanation on invitation to assessment session is offered to interested patients. 
  3. ImPress identifies the patients who are at most risk of cardiovascular disease and help them achieve optimal blood pressure management. They do this through teaching and supporting patients on lifestyles that decrease blood pressure, lead to less lifestyle risks, reduce body weight and adhere to medication advice (Stephen et al., 2019).
  4. Nurses consult on patients’ medical history individualized action planning, goal setting, and feedback in their sessions. The nurses guide the intervention program using the 5A's and motivational interviewing approaches to assist patients in their lifestyle changing journey. 
  5. As a result, the primary desired result is blood pressure, while the secondary desired outcomes include risk factors for heart disease and stroke.
  6. Patients' progress will be tracked for a period of six and twelve months. ImPress has a leg up on the competition when it comes to financial sustainability compared to other approaches (Stephen et al., 2019). Through Impress, patients with a high risk of cardiovascular disease will be taught a nurse-directed way of decreasing their blood pressure which benefits people with high blood pressure.


Ademi, Z., Ackerman, I. N., Zomer, E., & Liew, D. (2021). Productivity-adjusted life-years: a new metric for quantifying disease burden. Pharmacoeconomics39(3), 271-273.

Australian Institute of Health and Welfare. (2016). Australia's health 2016. Retrieved from https://www.aihw.gov.au/reports/australias-health/australias-health-2016

Australian Institute of Health and Welfare. (2019). Australian burden of disease study: impact and causes of illness and death in Australia 2015. Australian Institute of Health and Welfare.

Betts, J. M., Gao, C., Brown, D., Ikin, J., Maniam, R., Stub, D., ... & Liew, D. (2020). Factors associated with hypertension and its management among older rural Australians. Australian Journal of Rural Health28(4), 399-407.

Gaffari-Fam, S., Babazadeh, T., Oliaei, S., Behboodi, L., & Daemi, A. (2020). Adherence to a health literacy and healthy lifestyle with improved blood pressure control in Iran. Patient preference and adherence14, 499.

Head, G. A., Shaw, J. E., Dunstan, D. W., Owen, N., Magliano, D. J., Chadban, S., & Zimmet, P. (2019). Hypertension, white-coat hypertension and masked hypertension in Australia: findings from the Australian Diabetes, Obesity, and Lifestyle Study 3. Journal of Hypertension37(8), 1615-1623.

Hird, T. R., Zomer, E., Owen, A. J., Magliano, D. J., Liew, D., & Ademi, Z. (2019). Productivity burden of hypertension in Australia: a life table modeling study. Hypertension73(4), 777-784.

Mitsuyama, T., Son, D., & Eto, M. (2018). Competencies required for general practitioners/family physicians in urban areas versus non-urban areas: a preliminary study. BMC Family Practice19(1), 1-9.

Nguyen, B., Bauman, A., & Ding, D. (2019). Association between lifestyle risk factors and incident hypertension among middle-aged and older Australians. Preventive medicine118, 73-80.

STATISTICS, A. B. O. (2018). National Health Survey: First Results 2017-18. Canberra: ABS.

Stephen, C., Halcomb, E., McInnes, S., Batterham, M., & Zwar, N. (2019). Improving blood pressure control in primary care: The ImPress study. International journal of nursing studies95, 28-33.