Running head Pathophysiology 1

PATHOPHYSIOLOGY

STUDENTS’ NAME

INTRODUCTION

Pathophysiology is a scientific merge of two biological terms that is pathology and physiology. Pathology

on its own explains conditions that appear during disease state whereas physiology biologically describes

different activities that take place inside body of an organism (Dokken, 2019). Pathophysiology explains

how different diseases affect the normal functioning physiological processes in a body of an organism.

Generally in the whole world, it has been reported for the last 40 years hypertension and diabetes

prevalence to have escalated (MacGregor & Kaplan, 2010). In the year 2000 the disease prevalence was

approximately 2.8% which was prospected to rise up to 4.4% by the year 2030(Sturmberg, 2018). High

rate of obesity among the children predisposes higher cases of diabetes. As diabetic prevalence goes up

the more likely hypertension prevalence is. Renal diseases and cardiovascular diseases (CVD) are

contributed highly by infection of both diabetes and hypertension ("Hypertension: pathophysiology and

diagnosis", 2015). Co-existence of hypertension and diabetes jeopardizes the patients with other

opportunistic sufferings like heart diseases, retinopathy, stroke, nephropathy and CVD which leads to

increases morbidity and mortality rate among the population.

PATHOPHYSIOLOGY OF HYPERTENTION IN DIABETIC PATIENT

Different epidemiological studies have shown that the co- existence of hypertension and diabetes results

from similar genetic and environmental factors. Some of the physiological disorders that are likely to

show in Mr. Smith include; insulin resistance, hyperlipidemia, central obesity, increased tissue

inflammation and clustering hypertension (Saudek & Margolis, 2011). The patients is also symptomized

with high rate of sympathetic nervous system, high tissue renin-angiotensin-aldosterone system

commonly known as RAAS and failure of endothelial that resulted to reactive oxygen species production.
Running head Pathophysiology 2

INSULIN RESISTANCE

This is condition whereby cells do not respond to activities of hormone insulin. Insulin hormone is the

one responsible in glucose regulation in the body. The body releases this hormone whenever glucose is

present in the bloodstream (digestion of carbohydrates in the body). An action of insulin maintains normal

levels of glucose by converting the excess in to energy (Sturmberg, 2018). Insulin resistance is caused by

factors like obesity, being inactive, family history of diabetes, ordained with some medications and having

various health conditions. Insulin resistance leads to high glucose concentration in the blood than the

normal concentrations causing the individual to suffer from diabetes with co-existence of hypertension.

HYPERLIPIDEAMIA

This is a condition of elevated levels of lipids in the blood. It is grouped in to two that is primary and

secondary hyperlipidemia. Primary hyperlipidemia is genetically caused. The secondary hyperlipidemia is

caused by other factors including diabetes (Saudek & Margolis, 2011). The abnormal lipids levels in the

body may predispose other complications like CVD and acute pancreatitis.

INCREASED TISSUE INFLAMMATION

Inflammation is a state where body naturally responds to injuries, stress and trauma and originates from

the body’s immune system. A patients suffering from diabetes will have low grade inflammation

(Sturmberg, 2018). With elevated inflammation it will result to weight gain (obesity) which triggers

hypertension and also increased insulin resistance which leads to diabetes.

HIGH RATE OF SYMPATHETIC NERVE SYSTEM

Sympathetic nerve system is mandated to regulate blood pressure in the body. Therefore with impaired

sympathetic nervous system the individual will suffer from hypertension ("Treatment of Hyperte in

Adults with Diabetes", 2019). Predomination of hypertension leads to overworking of the sympathetic

nerves thus increasing their rates when trying to regulate the already elevated blood pressure.
Running head Pathophysiology 3

INTERPRETATION OF VITAL SIGNS AND FINDINGS OF THE EXAMINATION

Vital signs are parameters of normal body functions with which professional doctors examine in an

individual. These are four parameters which include; body temperature, pulse rate, respiration rate and

blood pressure (Cheriyan, McEniery & Wilkinson, 2010). These four vital signs were measured when Mr.

Smith visited the doctor and below is the discussion and interpretation of each vital sign.

BODY TEMPERATURE

In a healthy person the body temperature should range between 97.8F (36.5 degrees Celsius) to 99F (37.2

degrees Celsius). The body temperature may fluctuate due to factors such as recent activity, time of day,

fluid consumption, food, gender and in ladies during menstrual cycle. The parameters of temperature are

taken from the body through; skin, skin, orally, rectally and axillary ("Treatment of Hyperte n Adults with

Diabetes", 2019). In Mr. Smith findings from the doctors’ examination of his body temperature, his body

temperature was found to be 31 degrees Celsius which is below the normal body temperature. This

indication was due to fever which is known to alliterate the body temperature by either causing a rise or a

drop from the normal. Therefore Mr. Smith was experiencing fever in his ailment.

PULSE RATE.

This is the measurement of heart beat rates per minute. The heart beats due to contraction and expansion

of arteries of they push blood. The pulse rate also determines the heart rhythm and strength of the pulse.

In a normal person the pulse rate should always range from 60 to 100 beats per minute. Any alteration

from this parameter is said to be abnormal. The abnormal pulse rates are caused by illness, injury and

emotions. The pulse rate will depend on the activity, gender and age of the individual. From investigation

Mr. Smith pulse rate was found to be 100 beats per minute which is abnormal in consideration of his

gender, activity and age (Liu, 2 018). An increased pulse rate is one of the signs of hypertension.

Therefore Mr. Smith could be termed to be ailing from these findings of high rate of pulse.
Running head Pathophysiology 4

RESPERATION RATE

Respiration rate is the measure of the number of breaths per minute. Respiration rates are controlled in the

respiratory center. In a normal adult the respiration rate should be 12 – 18 breaths per minute. Alteration

of this normal range either by increment or decrement is due to fever, illness or any other medical

conditions (UK), 2019). . From the findings Mr. Smith’s rates of respiration was found to be 20 breaths

per minute which is higher from the normal range. The increased rate of respiration in his body is

characterized by his current medical conditions.

BLOOD PRESSURE

Blood pressure (BP) is the force of circulating blood that is experienced in the blood vessels. Blood

pressure is usually expressed in to two ways that is systolic pressure and diastolic pressure. In systolic the

blood pressure is maximum during one heartbeat whereas in diastolic the pressure is minimum during one

heartbeat. Blood pressure is measured in millitres mercury abbreviated as mmHg (UK), 2019). The

normal resting pressure should be 120mmHg in systolic and 80mmHg in diastolic which is written as

120/80mmHg. The normal resting parameter of blood pressure changes depending on situation, emotion,

activity done and health status in an individual. From the test that were carried out in Mr. Smith, they

indicated systolic pressure as 150mmHg and diastolic pressures as 95mmHg making his blood pressure to

be 150/95mmHg. From these findings, it is clear that Mr. Smith’s blood vessels were overworking in

circulating blood in his body. This condition is likely to be caused by his health complication

SIGNFICANCE OF BLOOD TESTS.

When a doctor is visited by a patient, he makes most of decisions based on the findings from the

laboratory results (Liu, 2 018). In the laboratory many elements from patients’ body are taken for

screening which include saliva, stool, urine and blood. Blood is the main components that the doctors will

depend on when identifying infections in individuals. Blood test is the most effective way of diagnosing
Running head Pathophysiology 5

diseases. Different blood test which are significantly done include; thyroid hormone test, complete blood

count, comprehensive metabolic panel (CMP0 blood test and Creatine phosphokinase (CPK) blood test.

COMPLETE BLOOD COUNT

This blood test is significantly done to determine the number of cells in the blood. The table below shows

descriptions of different blood counts that were done to Mr. Smith and their normal range.

Description Normal range Doctors findings from Mr. smith

Hb 138-172g/l 135g/l

RCC 4.7-6.1million cells per litter 4,500,000,000,000 cells per litter

Hct 40.7-50.3% 43%

Wee 4,500-10,000cells per litter 800,000,000cells per litter

Platelets 140,000-450,000cells per litter 180,000,000,000cells per litter

From the above blood counts obtained from the blood test the doctor is able to make informed decision on

sufferings of Mr. Smith.

THYROID HORMONE TEST

This test involves ordering the levels of thyroid stimulating hormone (TSH). The test is done to find out

the reason behind the failure of thyroid gland. This blood test was not done to Mr. Smith.

COMPREHENSIVE METABOLIC PANEL (CMP) BLOOD TEST

CMP blood test is done to determine metabolic functioning of body organs and their constituent mineral

contents ("Hypertension: pathophysiology and diagnosis", 2015). Parameters that are taken from this type

of blood test include; blood sugar levels, blood urea nitrogen concentrations, protein levels, calcium,
Running head Pathophysiology 6

potassium, carbon dioxide and chloride levels, Creatine ( detects dysfunction of the kidney) etc. from the

findings of CMP blood test of Mr. smith the doctor found out the results in the table below.

Description Normal range Doctor’s findings

Urea 7-20mg/dl 11mmol/L

Creatine 0.8-1.4mg/dl 0.3mmol/L

Glucose 64-128mg/dl 8mmol/L

CREATINE PHOSPHOKINASE (CPK) BLOOD TEST

CPK blood test is ordered to examine dysfunction or damage of muscle. The elevated levels of CPK

enzyme in the blood indicates an injured muscle since muscle cells contains CPK enzymes that can be

detected in the blood (Saudek & Margolis, 2011). This test was not done to Mr. Smith.

DIFFERENTIAL DIAGNOSIS OF THE PATIENT

In medicine differential diagnosis is the characteristics or clinical features that make a disease or a

medical condition distinct from the others (MacGregor & Kaplan, 2010). Mr. is termed to suffer from two

health conditions that are hypertension and diabetes. The following conditions could have developed on

Mr. Smith.

1. Heart failure

2. Apnea, sleep

3. Anxiety disorders

4. Stroke, ischemic

5. Stroke, hemorrhagic
Running head Pathophysiology 7

6. Amphetamine toxicity

7. Cocaine related cardiomyopathy

8. Primary aldosteronism

9. Myocardial infarction

10. Phencyclidine toxicity

11. Hyperthyroidism, Thyroid storm, and Grave Disease

12. Depression

13. Diabetes insipidus

14. Hypothyroidism

15. Metabolic X syndrome

16. Vitamin B 12

17. Vitamin B1

18. Alcohol induced peripheral neuropathy

19. Cushing’s syndrome

20. Multiple myeloma

SUGGESTIONS AND RATIONALE FOR FURTHER DIAGNOSTICTESTS

With elevated cases of numerous deaths due to hypertension and diabetes, it is recommendable that each

and every individuals to know his health status. Governments and non- governmental institutions

mandated with health issues have made it aware of these diseases to the public. It is initiative of each
Running head Pathophysiology 8

individual to visit clinical officers for the diagnosis of the disease ("Hypertension: pathophysiology and

diagnosis", 2015). This will allow people to take protective measures that eradicate domination of

hypertension and diabetes in our bodies. There are only three known diagnostic test for hypertension. This

includes; home blood pressure test, figure cuff blood pressure test and sphygmomanometer (arm cuff

blood pressure test).

This test can be done with machines that have been designed to help in diagnosis of the disease. Further

diagnostic test should be evolved that will help in detecting the diseases at early stages. With that it will

be easy to fight the disease and its negative results (Saudek & Margolis, 2011). One of the easiest ways of

diagnosing the disease is through observation of the physical signs and symptoms. The symptoms that are

predisposes of hypertension include; obesity, stress, anxiety, mental tension, obstructive sleep apnea,

headaches and nosebleeds. These symptoms are easily neglected and written off even by some medical

practitioners but they are some of key triggers of ailments like hypertension.

In the past 15 years technology was less effective than today (MacGregor & Kaplan, 2010). At earlier

times people could suffer from symptoms until the disease becomes severe that when it can be identified

and treatment measures taken. To date technology has made great miles in health sector. Advanced

machines that can detect disease in its early stages have been invented (Liu, 2 018). Researches on various

diseases, there causes and how they can be cured have be successfully done with the help of the new

technology. I would suggest that medical experts to utilize this advanced technology to come up with

more ways of diagnosing hypertension even on its first days in a patient. Also the medics should work

towards coming up with a vaccine against hypertension and diabetes.

CONCLUSION

At early times only few deaths were reported as a result of hypertension. Only people at their old age

were jeopardized by this disease but today it is even predominating to the tender aged person. The disease

has gone that viral due to change of our eating habits. People have refrained from taking natural foods and
Running head Pathophysiology 9

gone for the manufactured ones that contain a lot of additives that trigger ailments like hypertension and

diabetes. There is this old adage that goes prevention is better than cure. Therefore it a duty for each

individual to mind of the sorts of foods they take and also do a lot of exercise to stay healthy.

REFFERENCES
Running head Pathophysiology 10

1. (UK), N. (2019). Diagnosis of Hypertension. Retrieved 4 October 2019, retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK83278/

2. Cheriyan, J., McEniery, C., & Wilkinson, I. (2010). Hypertension. Oxford: Oxford University Press.

3. Dokken, B. (2019). The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood

Pressure and Lipids. Retrieved 4 October 2019

4. Hypertension: pathophysiology and diagnosis. (2015). Clinical Pharmacist. Doi:

10.1211/cp.2015.20067718

5. Liu, X. (2018). A0069 Evaluating the impact of an integrated computer-based decision support with

person-centered analytics for the management of hypertension. Journal of Hypertension, 36, e2. Doi:

10.1097/01.hjh.0000547994.70348.4

6. MacGregor, G., & Kaplan, N. (2010). Hypertension. Abingdon: Health Press.

7. Saudek, C., & Margolis, S. (2011). Diabetes. Baltimore, MD: Johns Hopkins Medicine.

8. Sturmberg, J. (2018). HYPE and TENSION in Hypertension. Debating the latest hypertension

guidelines. European Journal for Person Centered Healthcare, 6(1), 128. Doi: 10.5750/ejpch.v6i1.1509

9. Treatment of Hypertension in Adults with Diabetes. (2019). Retrieved 4 October 2019