I.

Introduction
Cardiovascular disease are the number one cause of death globally: more people
die annually from CVDs than from any other cause. An estimated 17.1 million people
died from CVDs in 2!" representing 2#$of all global deaths. %f these deaths" an
estimated 7.2 million &ere due to coronary heart disease and '.7 million &ere due to
stro(e.)o&* and middle*income countries are disproportionally affected: +2$ of CVD
deaths ta(e place in lo&* and middle*income countries and occur almost e,ually in men
and &omen. -y 2." almost 2../ million people &ill die from CVDs" mainly from heart
disease and stro(e. 0hese are pro1ected to remain the single leading causes of death. 0he
largest percentage increase &ill occur in the 2astern 3editerranean 4egion. 0he largest
increase in number of deaths &ill occur in the 5outh*2ast Asia 4egion. 6ypertension is
already a highly prevalent cardiovascular ris( factor &orld&ide because of increasing
longevity and prevalence of contributing factors such as obesity. 7hereas the treatment
of hypertension has been sho&n to prevent cardiovascular diseases and to e8tend and
enhance life" hypertension remains inade,uately managed every&here. 6ypertension
results &hen the body systems" &hich (eep the &idth of the arterioles and the fluid
volume of the blood in a normal relationship" become unbalanced. 0his disruption may
occur because of disease or some other influence. Disease" such as disorders of the
(idneys" certain tumors" or artery conditions" account for only about 1 percent of
hypertension cases. In the great ma1ority of patients" the precise cause remains un(no&n.
In these instances" the disorder is referred to as 9primary hypertension9 or 9essential
hypertension.9 Certain factors are (no&n to be influential in producing hyperten*sion.
:actors that may contribute to the development of hypertension include a fatty diet and
lac( of e8ercise ;&hich can lead to obesity< and too much salt in the diet. 6ypertension
also occasionally occurs in &omen &ho are ta(ing birth control pills. %ther factors
include diabetes" smo(ing" and e8cessive alcohol consumption. 6ypertension is estimated
to cause !.'$ of current global disease burden and is as prevalent in many developing
countries" as in the developed &orld. -lood pressure*induced cardiovascular ris( rises
continuously across the &hole blood pressure range. The age*standardi=ed I6D
1
mortality rate in men rose from ....

in 2+ to 7+. in 2#" and that of &omen from
1'.! to .!.'.

The age*standardi=ed 6>? mortality rate in men rose from 21.

in 2+ to
!'./ in 2#" and that of &omen from 1'./ to 2'.'.

The male to female ratios in the age*
standardi=ed death rates

for I6D" 6>? and also for all causes increased during this
period. Age*standardi=ed all causes mortality increased clearly

in the male population
but decreased in the female population

of the Philippines. 0his e8cess mortality in
males is mostly

due to the increased cardiovascular disease death rate. 0his

is a clear
e8ample of ho& chronic non*communicable diseases

are becoming ma1or health
problems in countries &here they previously

have not been prevalent. Immediate
preventive measures are needed

in order to control cardiovascular diseases in these
countries

&here disease rates are rapidly increasing.)ifestyle modification is
recommended for all individuals. 0here is evidence that specific agents have benefits for
patients &ith particular compelling indications" and that monotherapy is inade,uate for
the ma1ority of patients. :or patients &ithout a compelling indication for a particular drug
class" on the basis of comparative trial data" availability" and cost" a lo& dose of diuretic
should be considered for initiation of therapy. In most places a thia=ide diuretic is the
cheapest option and thus most cost effective" but for compelling indications &here other
classes provide additional benefits" even if more e8pensive" they may be more cost
effective. In high*ris( patients &ho attain large benefits from treatment" e8pensive drugs
may be cost effective" but in lo&*ris( patients treatment may not be cost*effective unless
the drugs are cheap. %ur patient 3r. Aguido @ebalay" '! years old" a residence of
-arangay 3aus&agon" >uro( 3alina&on" 3aragusan" had bee admitted due to right
lo&er ,uadrant pain" and increased blood pressure last Au.ly 1#" 21 and had been
diagnosed having ?ephrolithiasis" CAD" 6CVD" D32" @out" dyslipidemia" Diabetic
neuropathy" and been discharge last Auly 22" 21 after proper medical care.
0his study aims to have conceptual (no&ledge to us" student nurses as &ell as to
enhance our capabilities and (no&ledge regarding the appropriate things to do in the
actual setting. 0his case study had inspired the student nurses to provide &ith the building
bloc(s that help guide future actions and nursing practice &hich &ill enhance the
characteristic of being an efficient nurse
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