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UNIVERSITY OF PERPETUAL HELP SYSTEM -

JONELTA
Sto. Niño, Biñan, Laguna
COLLEGE OF NURSING
Since 1976
Chapter 1
THE PROBLEM AND ITS SETTING
Introduction
The most common alteration in blood pressure is hypertension.
Hypertension is an often asymptomatic disorder characterize by persistently
elevated blood pressure. The diagnosis of pre-hypertension in adults is made
when an average of two or more diastolic readings on at least two
subsequent visits is between 80 and 90 mm Hg or when the average of
multiple systolic blood pressures on two or more subsequent visits is between
120 and 140 mm Hg. Hypertension is noted with diastolic readings greater
than 90 mmHg and systolic readings greater than 140 mm Hg. One elevated
blood pressure measurement does not qualify as a diagnosis of hypertension.
However, if the nurse assesses a high reading during then first blood
pressure measurement (e.g. 150/90), the nurse is encouraged to return for
another check up within 2 months.
Persons with a family history of hypertension are not significant risk. Obesity,
cigarette smoking, heavy alcohol consumption, high sodium (salt) intake,
sedentary lifestyle, and continued exposure to stress are also linked to
hypertension. When clients are diagnosed with hypertension, the nurse helps
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JONELTA
COLLEGE OF NURSING
Since 1976
COLLEGE OF NURSING
Since 1976
to educate them about blood pressure values, long-term follow-up care and
therapy, the usual lack of symptoms (the fact that it may not be “felt”),
therapy’s ability to control but not cure hypertension, and a consistently
followed treatment plan that can ensure a relatively normal lifestyle.(NHBPEP,
2003)
Hypertension is one of the leading causes of morbidity in Barangay
Caingin Sta. Rosa, Laguna based to the 2006 survey on the local health
center in the area, that’s the primary reason why the researchers have
chosen the resident of Barangay Caingin as a respondent with regards to the
incidence of hypertension in Sta. Rosa Laguna.
Based on the 2006 health survey in Barangay Caingin Sta. Rosa,
Laguna hypertension is one of the top 10 common cases of morbidity. This is
the primary reason why the researchers have chosen the residents of
Barangay Caingin as its respondents with regards to the incidence of
hypertension in Sta. Rosa, Laguna.
This study aimed to discuss the level of awareness and practices on
the prevention of hypertension among selected respondents of Barangay
Caingin Sta. Rosa, Laguna. It generally aimed to determine the relationship

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COLLEGE OF NURSING
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COLLEGE OF NURSING
Since 1976
between the Baranggay Caingin respondent level of awareness and their
practices regarding the prevention of hypertension.
Theoretical Framework
Knowing the level of awareness and practices can help hypertensive
patient to lower their blood pressure. According to the study diagnosing
hypertension is above 140 mmHg as a systolic and 90 mmHg above as a
diastolic.
According to Edward Thorndike's theory, the primary law (law of effect)
can be summarized as: 'an act which results in an animal's experiencing
satisfaction in a given situation will generally become associated with that
situation, so that when it recurs the act will also be likely to recur'.
The theory represents the original stimulus-response (S-R) framework
of behavioral psychology. The classic example of this is a cat learning to
escape from a puzzle box by pressing a lever inside the box. The cat learns
to associate pressing the lever (S) with the opening of the door (R).
Satisfaction is achieved by escape from the box.
Thorndike's theories stressed that external reward is a more effective
factor than punishment in the modification of a learner's behavior. His theories
also suggested the importance of 'doing' and of repetition in the learning

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COLLEGE OF NURSING
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process. They also serve to remind teachers of the importance of motivation
in the preparation for learning and of the teacher's role in contributing towards
a learner's motivation.
These theories underpin basic teaching activity that would include
lesson planning, ensuring an orderly classroom, providing clear learning
objectives, progress from simple to more complex concepts, the importance
of practice and repetition, strengthening learner motivation, ensuring learners
are aware of the significance of the subject matter and providing them with an
ultimately satisfying outcome.
Conceptual Framework
This study deals with the level of awareness and practices on the
prevention of hypertension. The conceptual model shows the significant
relationship of independent and dependent variables. The first box is about
the demographic profile of the respondents in terms of age and educational
attainment while the second box is the level of awareness of the respondents
on the prevention of hypertension, which is both the independent variable.
The third box is the practices of the respondents on the prevention of
hypertension, which is the dependent variable.

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COLLEGE OF NURSING
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COLLEGE OF NURSING
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Independent Variable Dependent Variable
Hypertensive Level Of Practices on

Clients:
Awareness on Prevention of
• Age
Prevention of Hypertension
• Educational
Attainment Hypertension
Figure 1:
Conceptual Paradigm Illustrating the Level of Awareness and the
Practices on Prevention of Hypertension

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COLLEGE OF NURSING
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Statement of the Problem
This study aimed to determine the level of awareness and practices on
the prevention of hypertension among the selected respondents of Barangay
Caingin, Sta. Rosa, Laguna.
Specifically, the study sought to answer the following questions
1. What is the profile of the respondents in terms of:

1.1 Age
1.2 Educational Attainment
2. What is the level of awareness of the selected respondents of Barangay
Caingin Sta. Rosa, Laguna on the prevention of hypertension?
3. What are the practices employed on the prevention of hypertension
among the selected respondents of Barangay Caingin Sta. Rosa,Laguna?
4. Is there a significant relationship between demographic profile and level of
awareness on the prevention of hypertension among the selected
respondents of Barangay Caingin Sta. Rosa,Laguna?
5. Is there a significant relationship between demographic profile and
practices on the prevention of hypertension among the selected

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COLLEGE OF NURSING
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COLLEGE OF NURSING
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6. Is there a significant relationship between level of awareness and
practices on prevention of hypertension among the selected respondents
of Barangay Caingin, Sta. Rosa, Laguna?
Statement of the Hypothesis
The study tested the following hypothesis:
HO1. There is no significant relationship between demographic profile
and level of awareness on the prevention of hypertension among the selected
respondents of Barangay Caingin, Sta. Rosa, Laguna.
HO2. There is no significant relationship between demographic profile
and practices on the prevention of hypertension among the selected
respondents of Barangay Caingin, Sta. Rosa, Laguna.
HO3. There is no significant relationship between level of awareness
and practices on prevention of hypertension among the respondents of
Barangay Caingin, Sta. Rosa, Laguna.
Scope and Limitation of the Study

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COLLEGE OF NURSING
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COLLEGE OF NURSING
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The study focused on the level of awareness and practices among the
selected respondents of Barangay Caingin towards the prevention of
hypertension. The researchers purposively choose hypertensive respondents
to know their level of awareness and practices on preventing the
reoccurrence of hypertension.
Significance of the Study
The result of this study is beneficial to hypertensive clients, midwives,
nurses and future researchers.
Hypertensive client. They were the ultimate beneficiary of the study
for they will learn the importance of blood pressure monitoring thus they
comply regular check– up of their blood pressure.
Midwives. The result of this study will guide the midwives regarding
the content of their health teachings, and to conduct proper monitoring of their
blood pressure among respondents of Caingin. This study may provide them
information regarding the level of awareness and practices that would guide
them with their health teachings.

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COLLEGE OF NURSING
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Nurses. The result of this will give the nurses idea so that this will
serve as a basis for planning and implementation of health programs on
hypertension. This study will help them to improve their knowledge, skills, and
attitude concerning preventive healthcare through affective information
dissemination about hypertension.
Future Researchers. This study will serve as reference for future
studies using the same or different variables.
Definition of Terms:
The following terms and concepts were used and defined within the
context of the study.
Hypertension is a repeatedly elevated blood pressure with systolic
exceeding 140 mmHg and with a diastolic pressure above 90.
Level of Awareness is the level of understanding regarding
hypertension and practices of preventing it.
Practices are an action done by the respondents to prevent
hypertension.
Prevention is measures or means to avoid recurrence of hypertension.

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COLLEGE OF NURSING
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Chapter 2
REVIEW OF RELATED LITERATURE AND STUDIES
These are materials taken from the studies like thesis, research
journals, books and other reading materials that are related to the research
being conducted.
State of the Art
The Review of Related Literature and Studies provides information on
the topic, which are about the Level of Awareness and Practices on the
Prevention of Hypertension among the Selected Respondents of Barangay
Caingin. It also provides datas that are relevant to the research study.
Related Literature
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COLLEGE OF NURSING
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COLLEGE OF NURSING
Since 1976
MANILA, Philippines—Wrong information can be misleading and can
be literally disabling, as in the case of hypertensive patients who realize too
late that they had been clinging on to myths, which gave them a false sense
of complacency. Many are lucky to survive with gentle warnings, but some
pay dearly for their myths and misconceptions with lifelong disability and
sometimes, sadly, with sudden death. Doctors from the Philippine Society of
Hypertension (PSH), Philippine Lipid and Atherosclerosis Society (PLAS),
Philippine Heart Association (PHA), Stroke Society of the Philippines (SSP),
Foundation for Lay Education (FLED) and Department of Health (DOH)
regularly conduct lay forums which hopefully will correct many of these myths
which have been entrenched in the people’s minds as virtual facts.
Various medical organizations acknowledge the assistance of media
friends in educating the public. Pharmaceutical companies have also pitched
in their share to undertake these information campaigns.Recently, the PSH,
PHA and SSP collaborated on a massive trimedia hypertension awareness
blitz titled “Marunong ang nagtatanong!” The ads on radio, television and
newspapers tell everyone not to rely on well-meaning but misinformed
neighbors or friends, but to go to their family physicians or nearby health
center, have their BP checked and follow the doctor’s recommendations.This

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COLLEGE OF NURSING
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COLLEGE OF NURSING
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expensive campaign could not have pushed through without the generous
and selfless support of Therapharma and Unilab.
And the unspoken gratitude of every person whose life may have been
saved by the campaign will heap upon the company immeasurable
gratification, not in monetary currency, but something which goes with the
feeling that they have done their part without asking anything in return. To
John Dumpit and the other bosses at Therapharma and Unilab, may your
tribe increase.
Doctors may sound like broken records as they lecture to various
audiences even in far-flung areas (usually pro bono) but nothing can be more
encouraging to see that at the end of these forums, the lay participants have
a clearer and more accurate picture of what can potentially maim them. With
that, they are in a better position to prevent hypertension’s serious
complications.
High blood pressure is usually associated with symptoms, particularly
headache, dizziness, nervousness and anxiety.
Truth: Practically all hypertensive patients will not have any symptom in
the first 10-15 years of being hypertensive. Symptoms may be associated

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COLLEGE OF NURSING
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COLLEGE OF NURSING
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with damage to the vital organs such as the brain, heart and kidneys.
Symptoms associated with hypertension are also nonspecific and may be felt
with other conditions.
Medications should only be taken whenever one has symptoms
attributed to hypertension, or on an as-needed basis only.
Truth: This myth has led to many heart attacks and strokes in
previously no symptomatic individuals. Severe elevation of the BP when
under stress is normal and requires no treatment.
Truth: Even labile elevation of the BP may require treatment. Once the
BP breaches the limit equal to or more than 140/90 mmHg (especially if it
reaches 180/110 mmHg) and persists at this level for quite sometime, this
should be treated with concern.
Anemic patients have low BP; it’s impossible for them to become
hypertensive.
Truth: Unless the anemia is due to acute massive blood loss, many
anemic patients might even be hypertensive because of the increased heart
rate. Anemic patients due to chronic kidney disease might even be severely
hypertensive.
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If one has elevated cholesterol, one must also be hypertensive and
vice-versa.
Truth: Although hypertension and cholesterol problems may share the
same lifestyle risk factors, and may cluster together with diabetes and obesity
in a condition called metabolic syndrome, they don’t coexist all the time.
Hypertension becomes only complicated in men but not in women.
Truth: After menopause, when the female reproductive hormones are
already low and women lose their inherent protection from these hormones,
the incidence of heart attacks, strokes and other cardiovascular complications
become higher in women compared to men of the same age.
Over-the-counter (OTC) drugs for colds and weight reduction are safe
for hypertensive patients.
Truth: Decongestants, flu pills and some weight-reducing drugs can
trigger sudden BP increase. Some herbal preparations containing ephedra or
ma huang have also been reported to increase the BP. Always check first with
your doctor before taking these drugs or food supplements. Remember
always: Trust your doctor and “Marunong ang nagtatanong!” (Castillo, MD,
2008)
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COLLEGE OF NURSING
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COLLEGE OF NURSING
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MANILA, Philippines—Although medicines are needed by most
patients to control their blood pressure (BP), blood sugar or cholesterol levels,
the mainstay in the treatment of these risk factors is still strict compliance in
practicing simple lifestyle changes. “Lifestyle changes can help prevent high
BP, or control it in those who already have established hypertension,” says Dr.
Dante Aquino, secretary of the Philippine Society of Hypertension. High blood
pressure is diagnosed when the BP is consistently equal to or higher than
140/90 mmHg. “In high-risk patients with diabetes, previous heart attack or
stroke, chronic kidney disease and multiple risk factors, the BP should be
ideally less than 130/80 mmHg,” Dr. Morales advises. Lifestyle changes are
especially important for people who have risk factors that cannot be
changed – so - called non-modifiable risk factors, including family history,
gender, race, or age.
“There’s nothing that can be done about these non modifiable risk factors
but one can influence his other risk factors to prevent hypertension and
metabolic disorders such as diabetes and hypercholesterolemia,” explains Dr.
Ramon Abarquez Jr., past president of the Philippine Society of Hypertension
and one of the recognized pillars of Philippine cardiology.

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COLLEGE OF NURSING
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According to health experts, lifestyle changes include:
• Maintaining a normal weight, with a body mass index (BMI) of 18.5 to
23, computed by dividing weight in kg by height in meter squared.
• Reducing sodium in the diet to about 2.3 grams a day, which is about
one teaspoon of salt (Salt in cooking is allowed but not table sources of
salt; salt substitutes may be used).
• Exercising that raises the heart rate for at least 30 minutes a day on
most, preferably all days of the week (such as brisk walking, jogging,
dancing and aerobics).
• Limiting alcoholic drinks to at most two drinks a day for men, and one
drink a day for women
• Non- smoking and avoidance of people who smoke to prevent
secondhand smoking.
• Getting 3,500 mg of potassium in one’s diet every day (obtained by
ample servings of fruits and vegetables).
• Managing stress with enough sleep, recreation, meditation and
relaxation techniques.
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• Regular deep, slow breathing. (Having regular sessions of deep slow
breaths consisting of deep inhalation and slow exhalation through
pursed lips with rate of less than 10 breaths per minute can help lower
BP).
Dr. Abarquez, a professor emeritus at the University of the Philippines
College of Medicine, has coined the acronym SEX-HDL for healthy lifestyle
changes. It stands for: Smoking avoidance, Exercise, and Hypertension,
Diabetes and Lipid (cholesterol) control. He also recommends a family
approach such that the elders in the family inculcate this healthy lifestyle.
(Abarquez, 2008)
In spite of the availability of groups of medications that have been
introduced in the market (diuretics, peripheral inhibitors, central Alfa II
agonists, Alpha I receptor blockers, Beta receptor blockers, direct
vasodilators, calcium antagonists, ACE inhibitors, Angiotensin II blockers and
aldosterone blockers), only seven percent of all the world’s hypertensive
patients have well-controlled blood pressure. Dr. Adolfo B. Bellosillo,
president of the Foundation for Lay Education on Heart Diseases Inc., said
during the seventh national annual convention on Preventive Cardiology that
achieving normal blood pressure with antihypertensive medications remains

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an elusive goal for many hypertensives. Achieving normal BP levels is crucial
in the long-term, as this would prevent serious complications such as stroke,
acute heart failure and kidney failure. Bellosillo cited as some contributing
factors doctors’ failure to recognize the hemodynamics (the dynamics of blood
circulation that cause elevated blood pressure) involved in the elevation of
blood pressure and patients’ nonadherence to therapy. Bellosillo said blood
pressure goes up for a number of reasons, and there are two factors that
could lead to the failure to recognize the hemodynamics involved: the
peripheral resistance and the cardiac output (the output of the heart every
time it beats).. The body maintains normal blood pressure by adjusting
cardiac output and peripheral resistance. “If one or both is increased, this can
increase your blood pressure, but the question is: by the bedside or at the
clinic, how can we detect if the problem is peripheral resistance or the
increase in cardiac output or both?” he asked. In the past, doctors would
resort to right heart catheterization to pinpoint the root of the problem.
(Catheterization involves inserting a catheter -- a long, thin flexible tube -- into
the right side of the heart with the tip of the catheter positioned at the main
pulmonary artery to measure cardiac output and peripheral resistance).
Bellosillo said this process was expensive, would require special setups and
carried certain risk. No patient education. Bellosillo said, “We physicians

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failed to educate our hypertensive patients because the most commonly
heard word in the physician’s office is ‘Next! Next! Next!’ “We do not take the
time to sit with our patients and educate them about hypertension, the
importance of risk factors and what these medications are.”Unclear
instructions. Oftentimes, when doctors prescribe medication, either their
penmanship is not legible enough or their instructions are not specific.
Bellosillo cited as a commonly occurring example when medicines
were prescribed “once a day.” “What time of the day? There are 24 hours a
day and we know very well that when hypertension is being attacked, it must
be attacked at the proper time. The timing of intake of medicine is very
important because you know that when you’re treating hypertension, you are
only treating your patient to control the elevation of blood pressure to avoid
serious complications such as stroke, heart failure and heart attack. ”Lack of
involvement of patient in the treatment plan. Most of this Bellosillo said, is the
fault of the physician as “we do not educate (the patients). Lack of patient’s
education on the side effects. Bellosillo pointed out that many of these
medicines have side effects and that physicians failed to educate the patients
of these. Not knowing the side effects could cause panic among patient
memory deficit. This concerns more elderly patients. (Salazar, 2007)

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The Dietary Approaches to Stop Hypertension (DASH) diet is rich in
fruits, vegetables, and low-fat products and may have a BP-lowering effect
independent of its low sodium content. Eligible participants had BP levels
between 120-159/80-95 mmHg and were not taking antihypertensive
medication. Targeted enrollment was 50% African-American and 50% female.
Participants were randomized to either a control diet or the DASH diet. Within
each group, each participant was rotated through three sodium intake levels
(3000, 2400, and 1500 mg/d).
When compared with the control diet, the DASH diet resulted in a
significant lower SBP at every sodium level and a significantly lower DBP at
the high and intermediate sodium levels. The combination of the DASH diet in
a low-sodium intake (as compared with the control diet and high-sodium
intake) led to reduction in SBP that was 7.1 mmHg lower in participants
without hypertension and 11.5 mmHg in participants with hypertension. The
authors conclude that both the DASH diet and a reduction in sodium intake to
below 100 mmol/d result in a substantial lowering of blood pressure. The
maximum lowering is attained with two interventions combined. (Sacks MD,
2001)\
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Consuming dark chocolate, which is rich in flavanols, has been
demonstrated to decrease blood pressure and increases insulin sensitivity in
healthy subjects. Grassi and associates examined the cardiovascular benefits
of dark chocolate consumption in 20 patients with-never treated, grade I
essential hypertension. After a 7-day chocolate-free run-in phase, patients
were randomized to receive either 100g/d of dark chocolate (containing 88
mg flavanols) or 90 g/d of flavanol-free white chocolate in an isocaloric
manner for 15 days. After a second 7-day chocolate-free period, patients
were crossed over to the other treatment.
The results of this study suggest there are potential benefits of
chocolate flavanols on blood pressure, vasorelaxation, and insulin sensitivity
among patients with essential hypertension. The investigators noted,
however, that the dark chocolate used in this study had a higher flavanol
content that commercially available chocolate. They also urged caution when
consuming foods high in fat and calories, such as chocolate, particularly in
patients with cardiovascular disease. (Grassi, 2005)
Elderly persons have the highest rate of hypertension, yet data for
current rates 9of hypertension treatment, control, and risks among individuals
older than 80 years are sparse. Lloyd-Jones and colleagues examined these
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factors among older patients with hypertension using community-based data
from the Framingham Heart Study. A total of 5,296 participants were pooled
into three age groups: younger than 60 years, 60 to 80 years older. With
advancing age, relatively risks for cardiovascular disease associated with
increasing blood pressure stage did not decline, and absolute risks increased
markedly. Among participants 80 years and older , major cardiovascular
events occurred in 9.5% of the normal blood pressure group, 19.8% of the pre
hypertension group and 24.7% of the stage 2 or treated hypertension group.
Considering current national treatment guidelines, rates of blood
pressure control are low, particularly in older women. Data from this study
suggest that individuals 80 years or older may derive the most benefit from
associated with hypertension are substantial, the investigators call for greater
efforts at controlling blood pressure in the community. (Jones, 2005)
Cardiac responses to {beta}-adrenergic receptor stimulation are
depressed with pressure overload-induced cardiac hypertrophy. They
investigated whether exercise training could modify {beta} – adrenergic
receptor desensitizing kinase GRK2 and abundance and phosphorylation of

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some key Ca2+ cycling proteins. Exercise training in hypertension improves
the inotropic and lusiropic responsiveness to {beta} – adrenergic receptor
stimulation depite augmenting LV wall thickness. A lower GRK2 abundance
and an increased phosphorylation of key Ca2+ cycling proteins may be
responsible for the above putative effects. (Jefferson, 2005)
Know your blood pressure. Hypertension is a silent killer. You may feel
no symptoms yet the body is slowly being destroyed by high blood pressure.
Be proactive! Be aware of the risk! Have your blood pressure destroyed
checked regularly, at least once yearly. If your blood pressure level is
borderline or elevated (i.e. 140/90 mmHg and above) see your doctor. So
together you can make a plan to bring your blood pressure under control.
Live a healthy lifestyle. A healthy lifestyle keeps you less likely to
develop high blood pressure. You will also feel good knowing that you are
protected from hypertension. Among the healthy lifestyle you should consider
are as follows: regular exercise, watching your weight, keeping stress under
control, avoiding salty and fatty foods, avoiding too much caffeine, limiting
alcohol intake and quitting smoking.
Take your medication regularly. If you are consistently hypertension
despite undergoing a healthy lifestyle, your doctor will now prescribed a drug
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to combat your high blood pressure. Medications can safely and effectively
lower high blood pressure. (Tacio, 2004)
BP is the action of blood forcing itself against the interior walls of the
blood vessels of our body. And now does high blood pressure or hypertension
come about? When the normal flow of blood is being made difficult by
something, then someone's blood pressure becomes high. Most often that
happens when blood vessels become too narrow. This condition makes the
heart pump harder – in away doing a hard labor – to push the blood through
narrowing blood vessels. Consequently, this predicament makes one with
high BP a potential candidate for heart diseases, stroke, eye problems and
kidney diseases.
Generally, a hypertensive person has a BP that is above 140/90. But in
one with an underlying disease like diabetes, the ideal should be below
130/80. Medical science s increasingly convinced that high BP may be
caused by environmental factors such as, 1) family history of high BP 2) high-
sodium 3) excess alcohol 4) sedentary lifestyle (no exercise) 5) stress (work-
related among others); and 6) cigarette smoking.

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These factors are prevalent among adult Filipinos, many doctors will
admit that. That is why there is an alarming increase in the number of
hypertensive Filipinos, ranging 40-80 years old. (Cinco, 2005)
Pain or numbness in the nape area, headaches and getting dizzy often
could not necessarily mean that you are hypertensive. As a matter of fact,
people who have high blood pressure often do not present with any
identifiable symptoms that is why it is called a “silent killer”.
You may be going through your daily routines without even knowing
that your blood pressure is always is already way above ideal. The best way
to know if you are hypertensive is to have your BP checked by a health care
professional. One can be called hypertensive if his BP is persistently
elevated. An elevated BP is defined as BP reading 140/90.
For adults, the ideal BP should be maintained at less than or equal to
130/80. For me, the ideal BP for adults should be maintained at less than or
equal 120/70. The best way to manage hypertension is to change your
lifestyle.
Start with a healthy diet by eating less salt, avoiding monosodium
glutamate. Eating more fruits and vegetables. Avoiding smoking achieving

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ideal weight by reducing caloric intake and exercising regularly can also help
manage hypertension. (Dr. Reyes, 2007)
Hypertension is the medical term for high blood pressure. Most people
associate high blood pressure with getting older, so it may seem odd that
teens can have the condition. Although high blood pressure is rare in young
people (only about 1% to 3% of kids in the United States have hypertension),
it's important to check for it. Even babies can have high blood pressure! Most
blood pressure doesn't have a cause and is called essential or primary
hypertension. In cases where the cause of high blood pressure is known
(called secondary hypertension), it is usually the result of kidney problems,
hormonal disorders, abnormalities of the aorta (the main artery that carries
oxygenated blood to the body), or a narrowing of certain smaller arteries.
Doctors screen teens with high blood pressure for secondary causes with
physical examination and laboratory testing. Some teens may inherit the
tendency toward higher blood pressure from one or both parents. Although
hypertension often runs in families, some people with a strong family history
of high blood pressure may never develop it. Kids and teens who are obese
are at a higher risk for hypertension. Lack of exercise makes it easier to
become overweight and increases the chance of high blood pressure. People
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who drink a lot of alcohol or take illegal drugs like amphetamines and cocaine
are also at risk of developing the condition. In some cases, medications like
steroids or birth control pills can cause high blood pressure.
Pregnant women also may be diagnosed with hypertension. This type
of hypertension is known as preeclampsia (pronounced: pree-ih-klamp-see-
uh), or toxemia. It's uncommon, though: Only about 6% to 8% of pregnant
women get this condition.
Hypertension can be a temporary or lifelong disease, depending on the
cause. Regardless of what causes high blood pressure, the important thing is
to keep it under control. People who manage their high blood pressure with a
treatment program lower their risk of having serious complications as they get
older. Although medication may be necessary to control high blood pressure,
in many cases it can be managed with lifestyle improvements, such as weight
loss and dietary changes. If you've been diagnosed with hypertension, you
and your doctor will work as a team to decide on the best course of action for
you. Your doctor will most likely recommend that you make lifestyle changes
such as eating less fat and salt, avoiding alcohol and cigarettes, and making
sure you get plenty of exercise.

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Exercise is an important treatment for hypertension. Only people with
severe uncontrolled hypertension, which is very rare, need to be careful about
exercise. The American Academy of Pediatrics (AAP) recommends that teens
with severe hypertension avoid certain sports only until their hypertension is
under control. Sports on the "avoid" list include weight lifting and
bodybuilding, especially if done competitively — in other words, sports that
focus on building muscle mass but do not balance it with aerobic activity.
Here are some suggestions that can lessen your chances of
developing high blood pressure and help keep you healthy in many other
ways:
• Maintain a normal weight for your height.
• Exercise regularly. This can help prevent you from becoming
overweight or help you in losing pounds if you need to exercise also
helps keep your heart and blood vessels strong and healthy.
• Eat a healthy diet that includes mostly whole grains, low-fat dairy
products, fruits, and vegetables.
• Don't smoke. Smoking and high blood pressure are major risk factors
for having a heart attack or stroke later in life.

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• Keep your stress levels in check. It may help to practice relaxation
techniques such as deep breathing exercises.
• Decrease your sodium (salt) intake. Consuming less sodium has been
proven to help lower blood pressure in some people and may prevent
some from developing high blood pressure in the first place. Salt is
often found in breads, baked goods, and other processed/canned
foods.
• Avoid drinking too much alcohol, which is associated with high blood
pressure.
• Know your blood pressure. Have it checked regularly — although high
blood pressure is more common in adults, it can occur at any age.
(Gidding MD,2008)
PROVIDENCE , RHODE ISLAND . Researchers at Brown University
School of Medicine report that supplementation with aged garlic extract
lowers cholesterol levels and blood pressure in men with high cholesterol
levels. Their experiment involved 41 men aged 32 to 68 years who had total
cholesterol concentrations between 5.7 and 7.5 mmol/L (220-290 mg/dL) at
the start of the study. After a four-week baseline period half the men were
given nine aged garlic capsules (Wakunaga of America) daily. Each capsule
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contained 800 mg of aged garlic extract. The capsules were taken three at a
time with meals for a six-month period. The other half of the men were given
a placebo. At the end of the six- month period the supplementation was
changed so that the former garlic group was given the placebo and the
placebo group was given the aged garlic extract for an additional period of
four months. Cholesterol levels and blood pressure were measured monthly.
The researchers conclude that supplementation with aged garlic extract
lowers total cholesterol levels by an average of 6-7 per cent. Low-density-
lipoprotein cholesterol was lowered by an average of 4.6 per cent. The
researchers also noted a 5.5 per cent decrease in systolic blood pressure and
a smaller decrease in diastolic pressure. They found no adverse effects of
the garlic supplementation in regard to blood count, blood chemistry, or
thyroid function and conclude that garlic supplementation for extended
periods of time is safe and beneficial. (Steiner, 2004)
Related Studies
Researchers have spent decades developing new treatments for high
blood pressure, but exercise is still one of the best remedies around. A single
workout can reduce blood pressure for an entire day, and regular exercise
can keep the pressure down for the long run.

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What’s more, low to moderate intensity training appears to be as
beneficial – if not more so – as higher intensity training for reducing blood
pressure in people with hypertension, according to an article in the
September 200 issue of Sports Medicine. After analyzing 15 recent studies on
exercise and high blood pressure, reviewers concluded that exercise training
lowers blood pressure in a full 75 percent of people with hypertension.
Of course, exercise has many benefits beyond reducing blood
pressure. Even if your pressure doesn’t budge, exercise may strengthen
exercises for improving overall health and reducing the risk of subsequent
strokes. (Woolston, 2007)
Consuming less salt can not only lower blood pressure, but may
reduce the risk of heart disease overall, researchers reported. They found
that people with borderline-high blood pressure who reduced their sodium
intake by 25-35 percent lowered their risk of total cardiovascular disease by
25 percent. And this lower risk lasted for 10 to 15 years. Dr. Nancy Cook and
colleagues at Brigham and women’s hospital and Harvard Medical School in
Boston studied more than 3,000 people who took part of a low-salt diet and its
effects on high blood pressure.

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Those who are assigned to a low-salt diet had a low risk of all various
kinds of cardiovascular disease even 10 to 15 years later, they report on the
online version of the British Medical Journal. They were also 20 percent less
likely to have died than people assigned to a normal diet. “Our study provides
unique evidence that sodium reduction might prevent cardiovascular disease
and should dispel any residual concern that sodium reduction might be
harmful,” they wrote. Salt intake clearly linked to high blood pressure and the
National Heart, Lung and Blood institute, which paid for the study,
recommends that Americans cut down to sodium. More than 65 million US
adults – one in three – have unacceptability high blood pressure, above levels
of 140/90, the NHLBI said. Another 59 million have prehypertension – defined
as blood pressure of 120/80 or above. They average US and British diet
contain far more than 2,300 mg daily recommended by the NHLBI and
experts groups. Cook’s team said salt might affect artery and heart health by
ways that go beyond blood pressure. Sodium may make blood vessels less
able to expand and contract and may toughen heart cells, they said.
(Reuters, 2007)
For years, doctors had been taught in medical school that blood
pressure naturally increased with age and that a certain amount of

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hypertension in older people was acceptable. There was even a rough
guideline that normal blood pressure was 100 plus a person’s age.
Research presented here Monday suggests that formula may be
fatally flawed. In a study of 3,845 people over the age of 80 treating high
blood pressure resulted in a dramatic decrease in strokes, heart failure and
deaths from a variety of causes, compared with a placebo.
Getting patient’s blood pressure down to 150/80 led to a 21 percent
reduction in deaths from all causes; a 30 percent decrease in strokes and 39
percent cut in stroke deaths; and a 64 percent decrease in cases of heart
failure.
The benefit was so pronounced that researchers stopped the trial early
because it was considered unethical not to offer the treatment to the placebo
group. “This really dispels that myth (not to treat hypertension in older
people),” said Daniel Jones, dean of the school of medicine at the University
of Mississippi Medical Center. “It does it overwhelmingly.” Jones, who also
serves as president of the American heart association, said the findings
should change the way many doctors approach in treating high blood
pressure in people in their 70’s and 80’s. The study’s findings were presented
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at the American College of Cardiology annual meeting and published online in
the New England Journal of Medicine. Treating high blood pressure in older
people has long been a contentious issue.
Some observation studies have showed that higher blood pressure
was associated with decreased deaths in people over 80. But rigorous clinical
trials often had too few people had that age to be conclusive. In addition,
reducing blood pressure too much to older people can lead to side effects
such as dizziness and falling. The matter is further complicated by the fact
that many older people cannot afford to take the one or two blood pressure
medications that may be needed, said Steve Denson, a geriatrician and
hospitalist who practices at Froedtert Hospital and the Zablocki Veterans
Affairs Medical Center. “When you stack five or six prescription drugs, they
can run into serious cost of issues,” said Denson, an assistant professor of
medicine at the Medical College of Wisconsin in Wauwatosa.
However, the new study shows there is a clear benefit to treating high blood
pressure, said Denson. (Denson, 2008)
Two drugs which have revolutionized the treatment of cardiovascular
diseases in the past decade are the angiotensin receptors blockers (ARB)
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and angiotensin converting enzyme inhibitors (ACE). These two classes of
drugs, initially used for high blood pressure, are now also being used to
prevent other cardiovascular complications even in patients without
hypertension. Among the most scientifically proven ARB available to
physicians is telmisartan, a medicine belonging to the angiotensin II receptor
blockers class of drugs. GlaxoSmithKline, one of the world’s largest research-
based pharmaceutical companies, is co-sponsoring a landmark study with
Boehringer Ingelheim, which investigates the role of telmisartan in CVD
management. The ONTARGET (On Going Telmisartan Alone or in
combination with Ramipril Global Endpoint Trial) trial program is the world’s
largest cardiovascular protection trial using an angiotensin receptor blockers
(ARBs). Over 29,000 patients will be enrolled in the trial. Boehinger Ingelheim
is the main sponsor of the trial. This major trial is compromised of two parallel
trials: ONTARGET and Telmisartan Randomized Assessment study in ACE-I
Intolerant subjects with Cardiovascular Disease (TRANSCEND). It will
examine the preventive effects of telmisartans, either alone or in combination
with the ACE inhibitor ramipril, on stroke, heart attack, cardiovascular death
and hospitalization due to congestive heart failure. TRANSCEND will examine

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the effect of telmisartan compared to placebo (Dummy Pills) in patients
intolerant to an ACE-inhibitor. Results ONTARGET trial programmed, which
will be available 2008, are expected to improve the current treatment
guidelines used to treat hypertension and will help physicians and patients
achieve hypertension management. GSK is one of the world’s leading
research based pharmaceutical and healthcare companies. Its participation in
the ONTARGET Trial Programmed is part of the company’s continuing
commitment to improve the quality of human life. (Manila Bulletin, January
2004).
Adults who carry most of their excess weight around the middle may
be at particular risk of high blood pressure, new research shows. In a 10-year
study of Chinese adults, researchers found that those whose waistlines
expanded over the years showed a similar increase in blood pressure.
Moreover, even young men and women who were abdominally obese at the
start of the study, or who became so over time, were more likely to be
diagnosed with high blood pressure the findings appear in the American
journal of hypertension. Research shown that “apple shaped” people are at
greater risk of heart disease and type 2 diabetes than those whose extra
pounds dwell largely on the hips and thighs. Studies have also suggested that
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general obesity raises the risk of high blood pressure, or hypertension. But it
hasn’t been clear whether abdominal obesity, per se, can cause hypertension,
Dr. ChenHuan Chen, the study’s senior author, told Reuters Health. This
study may be the first to “clearly show” that abdominal obesity predicts future
hypertension, regardless of a persons current blood pressure or overall body
weight, said Chen, a professor of medicine at National Yang-Ming University
in Taipei, Taiwan. It is impossible, he noted, for a person to have a very large
waistline but not weight enough to be considered generally obese.
For their study, Chen and his colleagues followed 2,377 men and
women age 30 up for10 years, during which time one quarter developed high
blood pressure. Those with large waistlines at the outset had a higher risk
than their slimmer counterparts, as did people who became abdominally
obese during the study period. Even in a group of healthy adult’s ages 30 to
43 years, the researchers found that those whose waistlines expanded also
saw their blood pressure increase. Abdominal obesity often exist as part of
clusters of conditions known collectively as metabolic syndrome – the other
components being abnormal cholesterol levels, hypertension and insulin
resistance, a precursor to type 2 diabetes. It’s a complex collection of heart
risks, and it’s not fully clear which problem might cause the others. But the
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current findings support the theory that abdominal obesity is the “true culprit”
that spurs the development of insulin resistance, and then other components
of metabolic syndrome, according to Chen. If that’s the case, he noted, “it is
obvious that the most important thing to do is to prevent abdominal obesity,
not just obesity.”
There is no single definition of abdominal obesity, but in general, the
waist sizes used to define metabolic syndrome are 35 inches or more for
women and 40 inches or more for men. (Norton, September 2006)
BOSTON, MASSACHUSETTS. Doctors at the Harvard School of
Public Health have completed a study to determine the relationship between
diet and hypertension (high blood pressure). The study involved over 30,000
male health professionals 40 to 75 years old. The baseline mean systolic
blood pressure for the men was 125.5 mm at age 40-44 and 133.7 mm at age
70-75. The diastolic blood pressure at 79.3 to 80.4 mm was relatively
unchanged with age. During four years of follow-up 1248 of the men
developed hypertension. An analysis showed that participants consuming less
than 250 mg per day of magnesium had a 50% greater chance of developing
hypertension than had men who consumed 400 mg/day or more. Similarly, an
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intake of less than 2.4 g/day of potassium increased the risk of hypertension
by 50% as compared to an intake of 3.6 g/day or more.
The most striking effect was found in the case of dietary fiber where an
intake of 24 grams/day or more was found to provide significant protection. A
higher intake of dietary fiber, magnesium, and potassium was also found to
be associated with lower blood pressure in healthy men. The results of this
study confirm the findings of an earlier study involving 58,000 nurses. The
authors point out that although diet is important in preventing hypertension; its
effect is over shadowed by the risk imposed by obesity and excessive alcohol
intake. (Ascherio, November 2006)
AUGUSTA , GEORGIA . Researchers at the Medical College of
Georgia have confirmed that people with a high vitamin C concentration in
their blood have lower blood pressures than do people with little vitamin C.
They tested 168 healthy people, 56 of which were taking supplements
containing ascorbic acid. Among their findings: plasma ascorbic acid levels
were 11% higher in supplement users than in non-users; both diastolic and
systolic blood pressure were about 5 mm lower in people having a high
plasma level of vitamin C than in people having a low level. Blood levels of
selenium, vitamin A and vitamin E were not found to affect blood pressure, but
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both obesity and smoking had a significant adverse effect. (Moran, March
2005)
PORTLAND, OREGON Researchers at the Oregon Health Sciences
University have just published a major overview on the current knowledge
concerning the effect of dietary minerals on high blood pressure. They
conclude that the effect of sodium intake on blood pressure is still not clear. It
may be that only a subset of people with a genetic defect are sensitive to salt
intake. The chloride ion in itself does not seem to increase blood pressure,
but when combined with sodium it does cause hypertension in salt-sensitive
individuals.
A four-year study of 60,000 nurses concluded that women who have a
calcium intake of 800 mg/day or more have a 23 per cent lower risk of
developing high blood pressure than women with an intake of 400 mg/day or
less. The benefits of calcium are even greater among pregnant women.
Controlled trials have found that women who consume between 1500 - 2000
mg/day of calcium reduce their risk of developing pregnancy-induced
hypertension by as much as 50 per cent. It has also been shown that
maternal calcium intake directly affects the infant's blood pressure. Women
with a high calcium intake gave birth to babies with higher birth weights and
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lower blood pressures. This lower pressure persisted throughout at least the
first five years of life. The effect of potassium on blood pressure is still being
actively investigated. One trial found that a 50 per cent increase in potassium
from natural foods lowered blood pressure and dramatically reduced the need
for blood pressure-lowering drugs. Another trial found that supplementation
with potassium lowered blood pressure by 10 - 14 mm Hg. Several studies
suggest that a low magnesium intake is associated with hypertension, stroke,
and ischemic heart disease. It has been proposed that supplementation with
about 900 mg/day of magnesium, about 2.5 times the RDA, is required in
order to effectively lower blood pressure. (Reusser, November 2007)
Synthesis of the State of the Art
(Reuters, April 2007) consuming less salt can not only lower blood
pressure, but may reduce the risk of heart disease overall, researchers
reported“Our study provides unique evidence that sodium reduction might
prevent cardiovascular disease and should dispel any residual concern that
sodium reduction might be harmful,”
(Denson, April 2008) for years, doctors had been taught in medical
school that blood pressure naturally increased with age and that a certain
amount of hypertension in older people was acceptable.

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(Woolston, 2007) Researchers have spent decades developing new
treatments for high blood pressure, but exercise is still one of the best
remedies around. A single workout can reduce blood pressure for an entire
day, and regular exercise can keep the pressure down for the long run.
(Norton, September 2006) Adults who carry most of their excess
weight around the middle may be at particular risk of high blood pressure,
new research shows. In a 10-year study of Chinese adults, researchers found
that those whose waistlines expanded over the years showed a similar
increase in blood pressure. Research shown that “apple shaped” people are
at greater risk of heart disease and type 2 diabetes than those whose extra
pounds dwell largely on the hips and thighs. Studies have also suggested that
general obesity raises the risk of high blood pressure, or hypertension.
Gaps Bridged by the Present Study
The studies presented above are relevant to the present study. It has
almost same issues involving the level of awareness and practices on the
prevention of hypertension of the respondents associated with other
significant person. Almost all of the individuals entailed in the above studies
has made the same confessions and perceptions on the level of awareness
and practices on the prevention of hypertension as to being hypertensive

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themselves and how the situation they underwent change the perspective
they have towards a normal way of living.
A past interview was made written with some of the other hypertensive
and they ended up giving out the same perceptions of that of the respondents
involved in this study.
Chapter 3
RESEARCH DESIGN AND METHODOLOGY
This chapter will discuss about the research design to be use
consisting of description of the sources of data and sample, methodology,
description of instruments to be used in obtaining data and information, data
gathering procedure and statistical tools to be apply to answer the specific
questions raised.
Research Design
The researchers used a descriptive type of research. The use of the
descriptive method was described systematically a situation or area of

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interest factually and accurately. This kind of research method is used for
status trend studies dealing with the prevailing conditions of objects or
people. The researchers utilized descriptive type of research in order to
determine the level of awareness and the practices on the prevention of
hypertension.
Sources of Data
The researchers use books, journals, magazines and internet as
sources of data. The researcher went to the barangay hall of Barangay
Caingin Sta. Rosa, Laguna to deliver personally the letter of approval.
After request was granted the researchers conducted a survey by
distributing the questionnaire to the respondents. The researchers primary
source of data were the respondent’s profile, their level of awareness and
practices on the prevention of hypertension.
Participants of the Study
Based from the 2006 survey of the Rural Health Unit of Barangay
Caingin Sta. Rosa, Laguna, there were only seventy- seven individuals who
were hypertensive. But during the “Oplan Bantay - Presyon” conducted last
February 14, 2008 thirty residents were identified as hypertensive. The

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researchers have taken all identified hypertensive resident as their
respondent since they qualified under the criteria of hypertensive client having
a blood pressure of 140 and above systolic and 90 and above diastolic were
taken as respondent.
Sampling Technique
The researchers utilized purposive sampling technique. The
researchers used purposive sampling technique because only thirty residents
qualified to the criteria. The respondents who have a blood pressure of 140
systolic pressure and above and 90 diastolic pressure and above.
Instrumentation and Validation
Questionnaire was constructed after scanning from book, journals and
previous studies. It was written in understandable language provided with
instructions to follow to provide one accurate result based from the
respondents. The researchers developed a questionnaire in the form of
checklist which is consisted of three parts. Part I elicit of personal data of the
respondents in terms of age, gender, civil status and educational attainment.
Part II consists of questions to determine level of awareness on the

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prevention of hypertension. Part III consists of questions to determine the
After construction of questionnaire it was then validated by three
clinical instructors who were expert in the field of nursing. Suggestion and
recommendation were incorporated. The study utilized researchers made
questionnaires as tool in data gathering process and consist of several parts.
The researchers used Likert Scale Continuum type in determining level of
awareness and practices on the prevention of hypertension.
Data Gathering Procedure
Permission to conduct the study was secured from the Barangay Chairman,
and then the researcher obtained a list of individuals who are hypertensive
from the midwife assigned in the health center. After obtaining the address of
each hypertensive respondents, on July 4, 2008 the researcher conducted
the survey through house to house visit.
Evaluation and Scoring
The options to the items of the questionnaire that were in the Likert
Scale within the continuum of five were as follows with corresponding
assigned points.
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1.Level of Awareness on Prevention of Hypertension
Assigned Points Class Intervals Verbal Interpretation

5 4.51 – 5.00 Much Aware
4 3.51 – 4.50 Aware
3 2.51 – 3.50 Moderately Aware

2 1.51 – 2.50 Less Aware
1 1.00 – 1.50 Not Aware
2. Practices on Prevention of Hypertension
Assigned Points Class Intervals Verbal Interpretation

5 4.51 – 5.00 Always
4 3.51 – 4.50 Often
3 2.51 – 3.50 Sometimes
2 1.51 – 2.50 Seldom
1 1 – 1.50 Never
Statistical Treatment
The researchers utilized the following statistical tools in interpreting
data gathered.
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1. Frequency and percentage
This tool is used to describe the profile of the respondents who has
hypertension.
Formula used in percentage distribution:

P= f / N x 100
Where: P= percentage
F= number of responses
N= total no. of respondents
100= constant no.
2. Weighted Mean
This is the value which represents the whole distribution. It is used to
determine the extent level of awareness and practices to prevent
hypertension.
Formula for the weighted mean is as follows:
WM= ∑fx
∑f
Where: Wm = Weighted mean

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∑fx = the summation of the product of the frequency and
the
weights
∑f = the total no. of frequencies
The degree of intensity of responses, in the meantime, it is determined
using the following table of equivalents.
3. Ranking
After the weighted mean was computed, they were given the correct
and appropriate verbal interpretation, after which it was arranged according to
the size of the magnitude from highest and lowest.∑
It was used to prioritize degree of response given as they have been
consolidated.
4. Pearson r
It is used to determine the extent of relationship between level of
awareness and practices on the prevention of hypertension of the basic
assumptions for the used of the formula exists, then a Pearson r is solved by
the moment formula:

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r = nΣ xy-(Σx)(Σy)__________
√ [n (Σ x2)-(Σ x2)][n (Σ y2)- (Σy2)]
Where: x = predictor
n = the number of pairs
y = the criterion of pairs
∑ = Summation
In this study, the independent variables are the demographic profile
and level of awareness on prevention of hypertension while the practice on
the prevention of hypertension is the dependent variables.
For the relation using the r, the following descriptive were used:
Pearson r Interpretation
1.0 Perfect Relationship
0.80- 0.99 Very Strong Relationship
0.60- 0.79 Strong Relationship
0.40- 0.59 Moderate Relationship
0.20- 0.39 Weak Relationship

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0.01- 0.19 Very Weak Relationship
5. t-test
t- test was used to test the significance of Pearson r and is conducted
by the formula:
__________
t= r √_n – 2______
______
√1–r2
Where: t = the computed t value
n = sample size
r = Pearson r correlation coefficient
Chapter 4
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PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
This chapter involves data gathered and tabulated by the researchers.
The dates collected are presented in tables that give a visual representation
of the results study.
Table 1
Frequency and Percentage of the Demographic Profile of the

Respondents
Age:
61 and above 8 26.67
51 to 60 4 13.33
41 to 50 6 20.00
31 to 40 9 30.00
21 to 30 3 10.00
TOTAL 30 100
Educational
Attainment:
College 4 13.33
High School 14 46.67
Elementary 12 40.00
TOTAL 30 100
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Table 1 shows that, majority of the respondents belonged to the age
bracket of 31-40 years old (9) with a total of 30 percent, followed by the age
bracket of 61 and above (8) with a total of percentage of 26.67.
Then 20 percent belongs to the age bracket of 41-50 years old (6),
next is the age bracket of 51-60 years old (4) with a total percentage of 13.33
and 21- 30 age bracket (3) with a 10 percent of the total population.
In terms of educational attainment, most of the respondents were high
school graduate with percentage of 46.67, followed by Elementary Graduate
with percentage of 40.00, then 13.33 percent only were College Graduate.
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Table 2
Level of Awareness on the Prevention of Hypertension
Level of Awareness Weighted Interpretatio Rank

mean n
1. Hypertension is 3.53 Aware 1
hereditary so it needs to 0
take necessary precaution.
2. I need to seek medical 4017 Aware 2
consultation immediately
whenever I feel dizzy or
having nape pain
3. Exercise is one of the 4.13 Aware 4
preventive measures to
maintain blood pressure at
normal level.
4. Smoking is one of the 3.73 Aware 9
factors that contribute of
having high blood pressure.
5. I avoid too much salt 3.87 Aware 7

and cholesterol in my diet.
6. Obesity is one of the 3.77 Aware 8
risk factors of having
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hypertension so I have to
watch my weight.
7. I have to refrain from 4.03 Aware 6
too much alcohol intake
because it may elevate my
blood pressure.
8. BP monitoring is one 4.13 Aware 4
of the preventive measures
for developing
hypertension.
9. Intake of maintenance 4.13 Aware 4
drug is important to regulate
normal blood pressure.
10. I try to relax whenever I 4.47 Aware 1
am tired or under stress.
Average Weighted mean 4.00 Aware
As shown in table 2, respondents are aware that they need to relax
whenever they feel dizzy and having nape pain, as shown by the weighted
mean of 4.47 and 4.17 respectively. The respondents are also aware that
exercise, BP monitoring and intake of maintenance drug are important and
one of the preventive measure to prevent hypertension with equal weighted
mean of 4.13. Respondents also know that too much alcohol intake,
consuming food high in salt and cholesterol, obesity, smoking and having a
family history are the risk factors of hypertension with a weighted mean of
4.03, 3.87, 3.77, 3.73 and 3.53 respectively.

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Table 3
Practices on the Prevention of Hypertension
Practices in Preventing Weighted Interpretation Rank

Hypertension mean
1. I usually see my 3.33 Sometimes 5
doctor regularly to check
any tendency of
hypertension.
2. I take rest whenever I 4.17 Often 1
feel dizzy and having nape
pain.
3. I exercise regularly 3.20 Sometimes 8
every morning.
4. I absolutely avoid 3.23 Sometimes 7
smoking.
5. I avoid food with high 3.47 Sometimes 4
content of salt and
cholesterol.
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6. I prefer to eat 4.10 Often 2
vegetables and fruit than
meat.
7. I drink alcohol 2.63 Sometimes 10
moderately.
8. I subject myself for 3.13 Sometimes 9
blood pressure monitoring
at least 2-3 times a week.
9. I regularly take my 3.27 Sometimes 6
maintenance drug.
10. I do some diversional 4.03 Often 3
activities like reading
newspaper, listening to
music and watching
television whenever I face
with stressful situation.
Average weighted mean 3.46 Sometimes
As shown in table 3, the respondents practice taking rest whenever
they feel dizzy and having nape pain, with the weighted mean of 4.17. The
respondents prefer to eat vegetables and fruit rather than meat, with the
weighted mean of 4.10 the respondents often practice to do some diversional
activities like reading, listening to music and watching television when they
are in stressful situation and sometimes avoiding foods with high content of
salt and cholesterol as shown by the weighted mean of 4.03 and 3.47.
The respondents sometimes seek medical consultation for any
tendency of hypertension; also sometimes take their maintenance drug and

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absolutely avoid smoking as shown by the weighted mean of 3.33, 3.27 and
3.23. The respondents sometimes practice exercise regularly, subject
themselves for blood pressure monitoring and sometimes drink alcohol
moderately as shown by the weighted mean of 3.20, 3.13 and 2.53.
As a result the table shows that majority of the respondent’s practice
taking rest whenever they feel dizzy and having nuchial pain.
Table 4
Relationship between profile and Level of Awareness on the
prevention of Hypertension
Profile Pearson r Interpretation Computed Interpretation

value t value
Age -0.30 Weak 1.66 Not significant

relationship
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Educational 0.11 Very weak 0.59 Not significant
relationship
attainment
0.05 level of significance
Critical t Value = 2.048
As shown in table 4, for the relationship between age and the level of
awareness on the prevention of hypertension, a Pearson r value of – 0.30
was obtained which is interpreted as very weak relationship. A computed t
value of 1.66 which is lower than the critical t value of 2.048 at 0.05 level of
significance shows that there no significant relationship between age and the
practices on the prevention of hypertension. This means that the level of the
awareness on the prevention of hypertension is independent of age.
For the relationship between educational attainment and the level of
awareness on the prevention of hypertension, a Pearson r value of 0.11 was
obtained which is interpreted as very weak relationship.
A computed t value of 0.59 which is lower than the critical t value of
2.048 at 0.05 level of significance shows that there no significant relationship
between age and the practices on the prevention of hypertension. This means
that the level of awareness on the prevention of hypertension is independent
of educational attainment.
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Table 5
Relationship between Profile and Practices on the Prevention of
Hypertension
Profile Pearson r Interpretation Computed Interpretation

Value t Value
Age 0.16 Very weak 0.83 Not significant

relationship
Educational Very weak

Attainment 0.15 relationship 0.81 Not significant

Critical t Value = 2.048
As shown in table 5, for the relationship between age and the practices
on the prevention of hypertension, a Pearson r value of 0.16 was obtained
which is interpreted as very weak relationship. A computed t value of 0.83
which is lower than the critical t value of 2.048 at 0.05 level of significance
shows that there no significant relationship between age and the practices on
the prevention of hypertension. This means the practices on the prevention of
hypertension is independent of age.
For the relationship between educational attainment and the practices
on the prevention of hypertension, a Pearson r value of 0.15 was obtained

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which is interpreted as very weak relationship. A computed t value of 0.81
which is lower than the critical t value of 2.048 at 0.05 level of significance
shows that there no significant relationship between age and the practices on
the prevention of hypertension. This means the practices on the prevention of
hypertension is independent of educational attainment.
Table 6
Relationship between Level of Awareness and Practices in Preventing
Hypertension
Indicator Pearson r Interpretatio Compute Interpretation
Value n d t Value
Level of
Awareness Weak Not
and 0.22 relationship 1.17 significant
Practices on
the
Prevention
of
Hypertensio
n
Critical t value = 2.048
As shown in the table 6, for the relationship between level of awareness
and the practices on the prevention of hypertension, a Pearson r value of 0.22
was obtained which is interpreted as weak relationship. A computed t value of
1.17 was obtained which is lower than the critical t value of 2.048 at 0.05
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level of significance. This means that level of awareness is independent on
Chapter 5
SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

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This chapter summarizes the study, findings, conclusion and purpose
recommendations.
The purpose of this study is to determine the level of awareness and
practices regarding hypertension of respondents who have family history or
experiencing hypertension. The researchers utilized the purposive method
where only hypertensive residents in Barangay Caingin were taken as
respondents. The researchers made a self constructed survey form, and it
was distributed in order to gather data.
Specifically, the study sought to answer the following questions
1. What is the profile of the respondents in terms of:
1.1 Age
2. What is the level of awareness of the selected respondents of Barangay
Caingin Sta. Rosa, Laguna on the prevention of hypertension?
3. What are the practices employed on the prevention of hypertension
among the selected respondents of Barangay Caingin Sta. Rosa,Laguna?

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4. Is there a significant relationship between demographic profile and level of
awareness on the prevention of hypertension among the selected
5. Is there a significant relationship between demographic profile and
practices on the prevention of hypertension among the selected respondents
of Barangay Caingin Sta. Rosa,Laguna?
6. Is there a significant relationship between level of awareness and
practices on prevention of hypertension among the selected respondents of
Barangay Caingin, Sta. Rosa, Laguna?
Summary of findings
The summary of findings was arranged according to the statement of the
problem.
1. Demographic profile of the respondents.
The demographic profile of the respondents fell on 2 categories: Age
and educational attainment.
1.1 Age
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Majority of the respondents belonged to the age bracket of 31-40 years
old (9) with a total of 30%, followed by the age bracket of 61 and above (8)
with a total of percentage of 26.67%. Then 20% belongs to the age bracket of
41-50 years old (6), next is the age bracket of 51-60 years old (4) with a total
percentage of 13.33% and 21- 30 age bracket (3) with a 10% of the total
population
Most of the respondents were high school graduate with percentage of
46.67%, followed by Elementary Graduate with percentage of 40.00%, then
13.33% only were College Graduate
2. The level of Awareness of the selected respondents of Barangay Caingin
Sta. Rosa, Laguna showed that they were aware that they need to relax
whenever they feel tired and under stress, much of the fact that exercise,
blood pressure monitoring and intake of maintenance drugs are important and
one of the preventive measure to prevent hypertension. Last in the rank with
a weighted mean of 3.53, the respondents were aware that having a family
history is one of the risk factors of having hypertension.

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3. In terms of practices, in the prevention of hypertension, it showed that the
respondents entirely gave sometimes as an answer by having a weighted
mean of 3.46. Highest in the rank with a weighted mean of 4.17, the
respondents sometimes take rest whenever they were felt dizziness and
having nape pain and last in the rank with a weighted mean of 2.63, the
respondents sometimes drink alcohol moderately.
4. There is no significant relationship between the demographic profile and
the level of awareness on the prevention of hypertension. This means that the
level of awareness on the prevention of hypertension is independent of age
and educational attainment.
5. There is no significant relationship between the demographic profile and
practices on the prevention of hypertension. This means that practices on the
prevention of hypertension is independent of age and educational attainment
6. There is no significant relationship between the level of awareness on the
prevention of hypertension and the practices of the respondents in preventing
hypertension. This means that the level of awareness on the prevention of
hypertension is independent of practices.

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Conclusion
In the light of the above findings of the study, the following
conclusions can now be done.
1. Most of the respondents are in the middle young-aged, and who attained
high school level.
2. Respondents who participated in the study were aware regarding the ways
on how to prevent hypertension but they do not strictly practice the necessary
preventions.
3. Respondents who participated in the study only practice the prevention
when they already feel the symptoms. They would rather spend their money
in other things than spending it on maintenance drug.

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4. Profile such as age and educational attainment is not a contributing factor
for the respondents to be aware of preventing hypertension.
5. Likewise, in terms of practices that prevent hypertension, demographic
profile such as age and educational attainment is not a contributory factor.
6. Respondents are aware about their health condition but they do not strictly
practice all means to prevent hypertension.
Recommendation
Based on the findings of the study the researchers recommend the following
1. Screening of hypertension should also include younger age especially
those with history of hypertension so that treatment of hypertension will be
implemented and consequent complication will also be prevented
2. In order to increase the level of awareness of the respondent regarding
hypertension and its prevention, a seminar should be conducted to inform
them of the predisposing factors or causes hypertension.

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3. Likewise, it is important to emphasize to them that “Prevention is better
than cure”. Seminar can be conducted to educate residents of Barangay
Caingin on measures or means to prevent hypertension.
4. Health teachings can be conducted to those with history of hypertension
regardless of age and educational attainment of the participants.
BIBLIOGRAPHY
A. Books
Black & Hawks (2004). Management of Client with Hypertensive Disorders
Textbook of Medical-Surgical Nursing 7th Edition; pp. 1489
Caldwell,J.R. The Dropout Problem in Anti Hypertensive Treatment; pp.
579- 592
Smeltzer and Suddarth (2004) Textbook of Medical- Surgical Nursing 10th
Edition
B. Journals/ Periodicals
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COLLEGE OF NURSING
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Fahey, T. et al. Interventions use to Improve Control of Blood Pressure in
Patients with Hypertension. Cochrane database System revised 2003;
CDO05182
Journal of the American Medical Association. 2005; p. 294:466-472.
Donald M. Lloyd-Jones, MD, ScM; Jane C. Evans, DSc; Daniel Levy, MD
Bataclan M.G et.al Level of Compliance in Blood Pressure Monitoring and
intake of Maintenance Drugs among hypertensive Clients. December
2005
Ascherio, Alberto, et al. A prospective study of nutritional factors and
hypertension among US men. Circulation, Vol. 86, No. 5, November 2006,
pp. 1475-84
Moran, John P., et al. Plasma ascorbic acid concentrations relate inversely
to blood pressure in human subjects. American Journal of Clinical
Nutrition, Vol. 57, March 2005, pp. 213-17
Reusser, Molly E. and McCarron, David A. Micronutrient effects on blood
pressure regulation. Nutrition Reviews, Vol. 52, No. 11, November 2007,
pp. 367-75
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COLLEGE OF NURSING
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Steiner, Manfred, et al. A double-blind crossover study in moderately
hypercholesterolemic men that compared the effect of aged garlic extract
and placebo administration on blood lipids. American Journal of Clinical
Nutrition, Vol. 64, December 2004, pp. 866-70
C. Thesis
Macha, Osea,et al. Knowledge and Practices of the Hypertensive
Clients in Selected Areas of Barangay Dela Paz, Biñan Laguna
D. Internet or Website
www.controlhypertension.org/literature
www.bop.gov/news/PDFs/hypertension.pdf
www.current-report.com/article
www.jhypertension.com
http://kidshealth.org/teen/diseases_conditions/heart/hypertension.html
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APPENDICES
A. Demographic Profile
Please Check or fill in the blank the answer that describes you.
Name: (optional): ________________________
BP: _______________
Age:
________ 20 and below

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________ 21-30 years old
________ 31-40years old
________ 41-50 years old
________ 51-60 years old
________ 61 and above
Educational Background:
___________ College Graduate
___________ College Undergraduate
___________ High School Graduate
___________ High School Undergraduate
___________ Elementary Graduate
___________ Elementary Undergraduate
Please check the following questions that corresponds your answer.
5 – Much aware
4 – Aware
3 – Moderately aware
2 – Less aware
1 – Not aware
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A. Level of Awareness on the 5 4 3 2 1
Prevention of Hypertension
1. Hypertension is hereditary so it
needs to take necessary precaution.
2. I need to seek medical
consultation immediately whenever I
feel dizzy or having nape pain.
3. Exercise is one of the preventive
measures to maintain blood pressure
at normal level.
4. Smoking is one of the factors that
contribute of having high blood
pressure.
5. I avoid too much salt and
cholesterol in my diet
6. Obesity is one of the risk factors
of having hypertension so I have to
watch my weight.
7. I have to refrain from too much
alcohol intake because it may elevate
my blood pressure.
8. BP monitoring is one of the
preventive measures for developing
hypertension.
9. Intake of maintenance drug is
important to regulate normal blood
pressure
10. I try to relax whenever I am tired
or under stress.
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Please check the following questions that corresponds your answer.
5 – Always
4 – Often
3 – Sometimes
2 – Seldom
1 – Never
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B. Practices on the Prevention of 5 4 3 2 1
Hypertension
1. I usually see my doctor regularly to
check any tendency of hypertension.
2. I take rest whenever I feel dizzy and
having nape pain.
3. I exercise regularly every morning.
4. I absolutely avoid smoking.
5. I avoid food with high content of salt

and cholesterol.
6. I prefer to eat vegetables and fruit
than meat.
7. I drink alcohol moderately.
8. I subject myself for blood pressure

monitoring at least 2-3 times a week.
9. I regularly take my maintenance drug.
10. I do some diversional activities like

reading newspaper, listening to music and
watching television whenever I face with
stressful situation.
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PANUTO: Ang mga sumusunod ay nagpapahayag ng inyong kaalaman at

pang araw-araw na Gawain ukol sa hypertension. Lagyan ng (/) ang numerong
na sa inyong opinyon ay ang pinakatamang sagot.
5-Lubos na kaalaman
4-Sapat na kaalaman
3-katamtamang kaalaman
2-May kaunting nalalaman
1-Walang alam
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COLLEGE OF NURSING
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A. Kaalaman ng pagiwas sa hypertension. 5 4 3 2 1
1. Ang hypertension ay isang uri ng sakit na
namamana at kailangan nito ang karagdagang
pag-iingat upang maiwasan ito.
2. Ang mga sintomas katulad ng palagiang
pagkahilo at pagsakit ng batok ay nangangailangan
ng agarang konsultasyon sa doctor.
3. Ang ehersisyo ay isang paraan upang makaiwas
sa sakit na hypertension.
4.Ang paninigarilyo ay isa sa dahilan ng pagtaas ng
presyon.
5. Kumakain ng mga pagkaing hindi maalat, at
mataas sa kolesterol.
6. Ang pagiging overweight ay isa sa mga dahilan
sa pagkakaroon ng pagtaas ng presyon ng duso
kaya sinisigurado ko na nasa tama ang aking
timbang.
7. Kailangan iwasan ang sobrang paginom ng alak
dahil sa ito ay sanhi ng pagtaas ng presyon
8. Ang regular na pagkuha ng ating presyon isang
paraan upang makaiwas sa hypertension
9. Ang pag-inom ko ng gamut na nireseta sakin ng
aking doctor ay makakatulong upang mapanatili ko
ang normal na presyon ng aking dugo.
10. Nagpapahinga ako tuwing nakakaramdam ng
pagkapagod at sobrang stress.
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COLLEGE OF NURSING
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PANUTO: Ang mga sumusunod ay nagpapahayag ng inyong kaalaman at

pang araw-araw na Gawain ukol sa hypertension. Lagyan ng (/) ang numerong
na sa inyong opinyon ay ang pinakatamang sagot.
5-Palagiang ginagawa
4-Kadalasang ginagawa
3-Paminsan minsang ginagawa
2-Madalang na ginagawa
1-Hindi kailanman ginagawa
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COLLEGE OF NURSING
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B. Paraan sa pag-iwas ng mataas na presyon. 5 4 3 2 1
1. Regular akong komokonsulta sa doctor upang

malaman ang posibilidad sa maaring pagtaas ng
aking presyon.
2. Agad akong nagpapahinga kapag ako ay
nakakaramdam ng pagkahilo at pananakit ng batok.
3. Regular akong ngeehersisyo tuwing umaga
4. Iniiwasan ko ang paninigarilyo.
5. Iniiwasan ko ang pagkain ng maaalat at mataas sa
kolesterol.
6. Mas gusto kong kumain ng prutas at gulay kaysa
sa karne upang mapanatili ang aking timbang.
7. Tama lang ako kung uminomng alak.
8. Kusang loob akong nagpapatingin ng aking
presyon, dalawa hanggang tatlong beses sa isang
lingo.
9. Regular kong iniinom ang aking gamot na
nagpapanatili ng normal na presyon.
10. Para maiwasan ko ang labis na pagod o kapag
ako ay nakakaramdam ng pagod agad akong
nagpapahinga at nililibang ko ang aking sarili sa
pamamagitan ng pagbabasa, pakikinig sa radio,o
panonood ng telebisyon.
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CURRICULUM VITAE
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CURRICULUM VITAE
Name: Ma. Anna Vi A. Almendra

Nickname: Annie
Birth date: May 9, 1988
Age: 20
Home address: 124 Mercado Street Platero, Biñan, Laguna
E-mail Address: mannavi_einna@yahoo.com
Cellphone no.: 0927- 6540035
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Primary Education: Platero Elementary School

(1995 – 2000)
Secondary Education: Child Formation Center of Sta. Rosa
Laguna (2000- 2004)
Tertiary Education: UPH – Dr. Jose G. Tamayo Medical
University (2004-2008)
CURRICULUM VITAE
Name: Mary Grace M. Bantique

Nickname: Grace
Birth date: July 22, 1987
Age: 21
Home address: Tagaytay- Sta.Rosa road, Brgy. Tartaria, Silang,
Cavite
E-mail Address: mgbantigue@yahoo.com
Cellphone no.: 0915 - 7896866
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COLLEGE OF NURSING
Since 1976
Primary Education: Lumil Elementary School

(1995 - 2000)
Secondary Education: Lumil National High School
(2000- 2004)
CURRICULUM VITAE
Name: Dhon Patrick Camia

Nickname: Aldrin
Birth date: March 8, 1987
Age: 21
Home address: Mabuhay, Carmona, Cavite
E-mail Address: macooletz08@yahoo.com
Cellphone no.: 0927 - 7301894
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COLLEGE OF NURSING
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Primary Education: Carmona Elementary School

(1993 - 2000)
Secondary Education: Carmona National High School
(2000- 2004)
CURRICULUM VITAE
Name: Gretchin O. Gonzales

Nickname: Che- che
Birth date: June 29, 1986
Age: 22
Home address: Block 4-A Lot 15 Brgy. Ten Tiago GMA Cavite
E-mail Address: icylicious_cotalbex@yahoo.com
Cellphone no.: 0919 - 5891925
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COLLEGE OF NURSING
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Primary Education: San Jose Elementary School

(1994 - 1999)
Secondary Education: San Jose National High School
(1999 - 2003)
CURRICULUM VITAE
Name: Bonifacio I Brillo Martinez

Nickname: Bonie
Birth date: February 8, 1988
Age: 20
Home address: Block 6 Lot 19 Annex St. Camella Woodhills
E-mail Address: rambuxious_boy@yahoo.com
Cellphone no.: 0917 – 2438381
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JONELTA
COLLEGE OF NURSING
Since 1976
COLLEGE OF NURSING
Since 1976
Primary Education: Infant Jesus Montessori Center

(1995 – 2000)
Secondary Education: High School Liceo de San Pedro
(2000- 2004)
CURRICULUM VITAE
Name: Anna Danica C. Sta. Clara

Nickname: Nicca
Birth date: November 1, 1987
Age: 20
Home address: Doña Eusebia Village # 1 Concepcion San Pablo
City, Laguna
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COLLEGE OF NURSING
Since 1976
COLLEGE OF NURSING
Since 1976
E-mail Address: annadanica_staclara@yahoo.com
Cellphone no.: 0917 - 6604783
Primary Education: Canossa College San Pablo City

(1995 – 2000)
Secondary Education: Canossa College San Pablo City
(2000- 2004)

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1

UNIVERSITY OF PERPETUAL HELP SYSTEM -

THE PROBLEM AND ITS SETTING

The most common alteration in blood pressure is hypertension.

Hypertension is an often asymptomatic disorder characterize by persistently

elevated blood pressure. The diagnosis of pre-hypertension in adults is made

when an average of two or more diastolic readings on at least two

subsequent visits is between 80 and 90 mm Hg or when the average of

multiple systolic blood pressures on two or more subsequent visits is between

blood pressure measurement does not qualify as a diagnosis of hypertension.

pressure measurement (e.g. 150/90), the nurse is encouraged to return for

another check up within 2 months.

cigarette smoking, heavy alcohol consumption, high sodium (salt) intake,

sedentary lifestyle, and continued exposure to stress are also linked to

therapy’s ability to control but not cure hypertension, and a consistently

followed treatment plan that can ensure a relatively normal lifestyle.(NHBPEP,

Hypertension is one of the leading causes of morbidity in Barangay

chosen the resident of Barangay Caingin as a respondent with regards to the

incidence of hypertension in Sta. Rosa Laguna.

Based on the 2006 health survey in Barangay Caingin Sta. Rosa,

Laguna hypertension is one of the top 10 common cases of morbidity. This is

Barangay Caingin as its respondents with regards to the incidence of

hypertension in Sta. Rosa, Laguna.

This study aimed to discuss the level of awareness and practices on

the prevention of hypertension among selected respondents of Barangay

Caingin Sta. Rosa, Laguna. It generally aimed to determine the relationship

practices regarding the prevention of hypertension.

Knowing the level of awareness and practices can help hypertensive

patient to lower their blood pressure. According to the study diagnosing

hypertension is above 140 mmHg as a systolic and 90 mmHg above as a

According to Edward Thorndike's theory, the primary law (law of effect)

can be summarized as: 'an act which results in an animal's experiencing

satisfaction in a given situation will generally become associated with that

The theory represents the original stimulus-response (S-R) framework

of behavioral psychology. The classic example of this is a cat learning to

Satisfaction is achieved by escape from the box.

Thorndike's theories stressed that external reward is a more effective

factor than punishment in the modification of a learner's behavior. His theories

also suggested the importance of 'doing' and of repetition in the learning

These theories underpin basic teaching activity that would include

lesson planning, ensuring an orderly classroom, providing clear learning

objectives, progress from simple to more complex concepts, the importance

of practice and repetition, strengthening learner motivation, ensuring learners

ultimately satisfying outcome.

prevention of hypertension. The conceptual model shows the significant

relationship of independent and dependent variables. The first box is about

the demographic profile of the respondents in terms of age and educational

on the prevention of hypertension, which is both the independent variable.

The third box is the practices of the respondents on the prevention of

hypertension, which is the dependent variable.

Independent Variable Dependent Variable

Hypertensive Level Of Practices on

Conceptual Paradigm Illustrating the Level of Awareness and the

Practices on Prevention of Hypertension

Statement of the Problem

This study aimed to determine the level of awareness and practices on

the prevention of hypertension among the selected respondents of Barangay

Caingin, Sta. Rosa, Laguna.

Specifically, the study sought to answer the following questions

1. What is the profile of the respondents in terms of:

Caingin Sta. Rosa, Laguna on the prevention of hypertension?

3. What are the practices employed on the prevention of hypertension