bad behavior hypertension

8/2/2019 Bad Behavior Hypertension

1/16

INTRODUCTION TO BEHAVIORUAL SCIENCESApril 30,

2012

Lahore Business School (LBS) Submitted By: Ali Adnan

Introduction To Behavioral Sciences

Project

Topic: Bad Behavior

SectionA

BBA 02093

Submitted by:

Ali Adnan

Submitted To:

Mam Shazia Gulzar

Lahore Business School (LBS)

University of Lahore (UOL)


2/16


2012


Bad behavior

Hypertension, most commonly referred to as "high blood pressure" or HTN, is a medical

condition in which the blood pressure is chronically elevated. It was previously referred to as

arterial hypertension, but in current usage, the word "hypertension" without a qualifier normallyrefers to arterial hypertension.

Hypertension can be classified as either essential (primary) or secondary. Essential hypertension

indicates that no specific medical cause can be found to explain a patient's condition. Secondary

hypertension indicates that the high blood pressure is a result of (i.e. secondary to) anothercondition, such as kidney disease or certain tumors (especially of the adrenal gland). Persistent

hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial

aneurysm, and is a leading cause ofchronic renal failure. Even moderate elevation of arterial

blood pressure leads to shortened life expectancy. At severely high pressures, defined as meanarterial pressures 50% or more above average, a person can expect to live no more than a few

years unless appropriately treated.

Hypertension is considered to be present when a person's systolic blood pressure is consistently

140 mmHg or greater, and/or their diastolic blood pressure is consistently 90 mmHg or greater.

Recently, as of 2003, the Seventh Report of the Joint National Committee on Prevention,

Detection, Evaluation, and Treatment of High Blood Pressure has defined blood pressure 120/80

mmHg to 139/89 mmHg as "prehypertension." Prehypertension is not a disease category; rather,

it is a designation chosen to identify individuals at high risk of developing hypertension. TheMayo Clinic website specifies blood pressure is "normal if it's below 120/80" but that "some data

indicate that 115/75 mm Hg should be the gold standard." In patients with diabetes mellitus or

kidney disease studies have shown that blood pressure over 130/80 mmHg should be considered

high and warrants further treatment. Even higher numbers are considered diagnostic using homeblood pressure monitoring devices.

Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronicmedical condition in which the blood pressure in the arteries is elevated. This requires the heart

to work harder than normal to circulate blood through the blood vessels. Blood pressure involves

two measurements, systolic and diastolic, which depend on whether the heart muscle iscontracting (systole) or relaxed between beats (diastole). Normal blood pressure at rest is within

the range of 100-140mmHg systolic (top reading) and 60-90mmHg diastolic (bottom reading).

High blood pressure is said to be present if it is persistently at or above 140/90 mmHg.

Hypertension is classified as either primary (essential) hypertension or secondary hypertension;about 9095% of cases are categorized as "primary hypertension" which means high bloodpressure with no obvious underlying medical cause. The remaining 510% of cases (secondary

hypertension) is caused by other conditions that affect the kidneys, arteries, heart or endocrine

system.

Hypertension is a major risk factor for stroke, myocardial infarction (heart attacks), heart failure,

aneurysms of the arteries (e.g. aortic aneurysm), peripheral arterial disease and is a cause of
http://psychology.wikia.com/wiki/Blood_pressurehttp://psychology.wikia.com/wiki/Arteryhttp://psychology.wikia.com/wiki/Essential_hypertensionhttp://psychology.wikia.com/wiki/Secondary_hypertension?action=edit&redlink=1http://psychology.wikia.com/wiki/Secondary_hypertension?action=edit&redlink=1http://psychology.wikia.com/wiki/Kidney_diseasehttp://psychology.wikia.com/wiki/Tumorhttp://psychology.wikia.com/wiki/Adrenal_glandhttp://psychology.wikia.com/wiki/Strokehttp://psychology.wikia.com/wiki/Myocardial_infarctionhttp://psychology.wikia.com/wiki/Heart_failurehttp://psychology.wikia.com/wiki/Aneurysmhttp://psychology.wikia.com/wiki/Chronic_renal_failurehttp://psychology.wikia.com/wiki/Mean_arterial_pressurehttp://psychology.wikia.com/wiki/Mean_arterial_pressurehttp://psychology.wikia.com/wiki/Systole_%28medicine%29http://psychology.wikia.com/wiki/Torr?action=edit&redlink=1http://psychology.wikia.com/wiki/Diastolehttp://psychology.wikia.com/wiki/Prehypertension?action=edit&redlink=1http://www.mayoclinic.com/health/high-blood-pressure/DS00100/DSECTION=6http://psychology.wikia.com/wiki/Diabetes_mellitushttp://psychology.wikia.com/wiki/Nephropathy?action=edit&redlink=1http://en.wikipedia.org/wiki/Chronic_%28medicine%29http://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Essential_hypertensionhttp://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Risk_factorhttp://en.wikipedia.org/wiki/Strokehttp://en.wikipedia.org/wiki/Myocardial_infarctionhttp://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Aneurysmhttp://en.wikipedia.org/wiki/Aortic_aneurysmhttp://en.wikipedia.org/wiki/Peripheral_arterial_diseasehttp://en.wikipedia.org/wiki/Peripheral_arterial_diseasehttp://en.wikipedia.org/wiki/Aortic_aneurysmhttp://en.wikipedia.org/wiki/Aneurysmhttp://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Myocardial_infarctionhttp://en.wikipedia.org/wiki/Strokehttp://en.wikipedia.org/wiki/Risk_factorhttp://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Essential_hypertensionhttp://en.wikipedia.org/wiki/Arteryhttp://en.wikipedia.org/wiki/Blood_pressurehttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/Chronic_%28medicine%29http://psychology.wikia.com/wiki/Nephropathy?action=edit&redlink=1http://psychology.wikia.com/wiki/Diabetes_mellitushttp://www.mayoclinic.com/health/high-blood-pressure/DS00100/DSECTION=6http://psychology.wikia.com/wiki/Prehypertension?action=edit&redlink=1http://psychology.wikia.com/wiki/Diastolehttp://psychology.wikia.com/wiki/Torr?action=edit&redlink=1http://psychology.wikia.com/wiki/Systole_%28medicine%29http://psychology.wikia.com/wiki/Mean_arterial_pressurehttp://psychology.wikia.com/wiki/Mean_arterial_pressurehttp://psychology.wikia.com/wiki/Chronic_renal_failurehttp://psychology.wikia.com/wiki/Aneurysmhttp://psychology.wikia.com/wiki/Heart_failurehttp://psychology.wikia.com/wiki/Myocardial_infarctionhttp://psychology.wikia.com/wiki/Strokehttp://psychology.wikia.com/wiki/Adrenal_glandhttp://psychology.wikia.com/wiki/Tumorhttp://psychology.wikia.com/wiki/Kidney_diseasehttp://psychology.wikia.com/wiki/Secondary_hypertension?action=edit&redlink=1http://psychology.wikia.com/wiki/Secondary_hypertension?action=edit&redlink=1http://psychology.wikia.com/wiki/Essential_hypertensionhttp://psychology.wikia.com/wiki/Arteryhttp://psychology.wikia.com/wiki/Blood_pressure


3/16


2012


chronic kidney disease. Even moderate elevation of arterial blood pressure is associated with ashortened life expectancy. Dietary and lifestyle changes can improve blood pressure control and

decrease the risk of associated health complications, although drug treatment is often necessary

in people for whom lifestyle changes prove ineffective or insufficient.

Adults

In people aged 18 years or older hypertension is defined as a systolic and/or a diastolic bloodpressure measurement consistently higher than an accepted normal value (currently 139 mmHg

systolic, 89 mmHg diastolic: see tableClassification (JNC7)). Lower thresholds are used(135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour

ambulatory or home monitoring. Recent international hypertension guidelines have also created

categories below the hypertensive range to indicate a continuum of risk with higher blood

pressures in the normal range. JNC7 (2003) uses the term prehypertension for blood pressure inthe range 120-139 mmHg systolic and/or 80-89 mmHg diastolic, while ESH-ESC Guidelines

(2007) and BHS IV (2004) use optimal, normal and high normal categories to subdivide

pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified:JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic

hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal

diastolic pressure and is common in the elderly. The ESH-ESC Guidelines (2007) and BHS IV

(2004), additionally define a third stage (stage III hypertension) for people with systolic bloodpressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is

classified as "resistant" ifmedications do not reduce blood pressure to normal levels.

Neonates and infants

Hypertension in neonates is rare, occurring in around 0.2 to 3% of neonates, and blood pressureis not measured routinely in the healthy newborn. Hypertension is more common in high risk

newborns. A variety of factors, such as gestational age, postconceptional age and birth weightneeds to be taken into account when deciding if a blood pressure is normal in a neonate.

Children and adolescents

Hypertension occurs quite commonly in children and adolescents (2-9% depending on age, sexand ethnicity) and is associated with long term risks of ill-health. It is now recommended that

children over the age of 3 have their blood pressure checked whenever they attend for routine

medical care or checks, but high blood pressure must be confirmed on repeated visits before

characterizing a child as having hypertension. Blood pressure rises with age in childhood and, in

children, hypertension is defined as an average systolic or diastolic blood pressure on three ormore occasions equal or higher than the 95th percentile appropriate for the sex, age and height of

the child. Prehypertension in children is defined as average systolic or diastolic blood pressure

that is greater than or equal to the 90th percentile, but less than the 95th percentile. Inadolescents, it has been proposed that hypertension and pre-hypertension are diagnosed and

classified using the same criteria as in adults.
http://en.wikipedia.org/wiki/Chronic_kidney_diseasehttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Pharmaceutical_drughttp://en.wikipedia.org/wiki/Neonateshttp://en.wikipedia.org/wiki/Gestational_agehttp://en.wikipedia.org/wiki/Birth_weighthttp://en.wikipedia.org/wiki/Birth_weighthttp://en.wikipedia.org/wiki/Gestational_agehttp://en.wikipedia.org/wiki/Neonateshttp://en.wikipedia.org/wiki/Pharmaceutical_drughttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Chronic_kidney_disease


4/16


2012


Signs and symptoms

Hypertension is rarely accompanied by any symptoms, and its identification is usually throughscreening, or when seeking healthcare for an unrelated problem. A proportion of people with

high blood pressure reports headaches (particularly at the back of the head and in the morning),

as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision orfainting episodes.

On physical examination, hypertension may be suspected on the basis of the presence ofhypertensive retinopathy detected by examination of the optic fundus found in the back of the

eye using ophthalmoscopy.[10]

Classically, the severity of the hypertensive retinopathy changes is

graded from grade IIV, although the milder types may be difficult to distinguish from each

other.[10]

Ophthalmoscopy findings may also indicate how long a person has been hypertensive.

Secondary hypertension

Some additional signs and symptoms may suggest secondary hypertension, i.e. hypertension due

to an identifiable cause such as kidney diseases or endocrine diseases. For example, tranceobesity, glucose intolerance, moon faces, a "buffalo hump" and purple striate suggest Cushing's

syndrome. Thyroid disease and acromegaly can also cause hypertension and have characteristic

symptoms and signs. An abdominal bruit may be an indicator ofrenal artery stenosis (anarrowing of the arteries supplying the kidneys), while decreased blood pressure in the lower

extremities and/or delayed or absent femoral arterial pulses may indicate aortic coarctation (a

narrowing of the aorta shortly after it leaves the heart). Labile or paroxysmal hypertension

accompanied by headache, palpitations, pallor, and perspiration should prompt suspicions ofpheochromocytoma.

Hypertensive crises

Severely elevated blood pressure (equal to or greater than a systolic 180 or diastolic of 110 sometime termed malignant or accelerated hypertension) is referred to as a "hypertensive crisis",

as blood pressures above these levels are known to confer a high risk of complications. People

with blood pressures in this range may have no symptoms, but are more likely to reportheadaches (22% of cases) and dizziness than the general population. Other symptoms

accompanying a hypertensive crisis may include visual deterioration or breathlessness due to

heart failure or a general feeling ofmalaise due to renal failure. Most people with a hypertensive

crisis are known to have elevated blood pressure, but additional triggers may have led to a

sudden rise.

A "hypertensive emergency", previously "malignant hypertension", is diagnosed when there isevidence of direct damage to one or more organs as a result of the severely elevated blood

pressure. This may include hypertensive encephalopathy, caused by brain swelling and

dysfunction, and characterized by headaches and an altered level of consciousness (confusion ordrowsiness). Retinal papilledema and/or fundal hemorrhages and exudates are another sign of

target organ damage. Chest pain may indicate heart muscle damage (which may progress to
http://en.wikipedia.org/wiki/Screening_%28medicine%29http://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Occiputhttp://en.wikipedia.org/wiki/Lightheadednesshttp://en.wikipedia.org/wiki/Vertigohttp://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Syncope_%28medicine%29http://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Hypertensive_retinopathyhttp://en.wikipedia.org/wiki/Optic_fundushttp://en.wikipedia.org/wiki/Ophthalmoscopyhttp://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Kidney_diseaseshttp://en.wikipedia.org/wiki/Endocrine_diseaseshttp://en.wikipedia.org/wiki/Glucose_intolerancehttp://en.wikipedia.org/wiki/Moon_facieshttp://en.wikipedia.org/wiki/Striaehttp://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Thyroid_diseasehttp://en.wikipedia.org/wiki/Acromegalyhttp://en.wikipedia.org/wiki/Bruithttp://en.wikipedia.org/wiki/Renal_artery_stenosishttp://en.wikipedia.org/wiki/Femoral_arteryhttp://en.wikipedia.org/wiki/Aortic_coarctationhttp://en.wikipedia.org/wiki/Labilehttp://en.wikipedia.org/wiki/Pheochromocytomahttp://en.wikipedia.org/wiki/Malaisehttp://en.wikipedia.org/wiki/Hypertensive_encephalopathyhttp://en.wikipedia.org/wiki/Altered_level_of_consciousnesshttp://en.wikipedia.org/wiki/Papilloedemahttp://en.wikipedia.org/wiki/Hemorrhageshttp://en.wikipedia.org/wiki/Exudateshttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Acute_coronary_syndromehttp://en.wikipedia.org/wiki/Acute_coronary_syndromehttp://en.wikipedia.org/wiki/Chest_painhttp://en.wikipedia.org/wiki/Exudateshttp://en.wikipedia.org/wiki/Hemorrhageshttp://en.wikipedia.org/wiki/Papilloedemahttp://en.wikipedia.org/wiki/Altered_level_of_consciousnesshttp://en.wikipedia.org/wiki/Hypertensive_encephalopathyhttp://en.wikipedia.org/wiki/Malaisehttp://en.wikipedia.org/wiki/Pheochromocytomahttp://en.wikipedia.org/wiki/Labilehttp://en.wikipedia.org/wiki/Aortic_coarctationhttp://en.wikipedia.org/wiki/Femoral_arteryhttp://en.wikipedia.org/wiki/Renal_artery_stenosishttp://en.wikipedia.org/wiki/Bruithttp://en.wikipedia.org/wiki/Acromegalyhttp://en.wikipedia.org/wiki/Thyroid_diseasehttp://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Striaehttp://en.wikipedia.org/wiki/Moon_facieshttp://en.wikipedia.org/wiki/Glucose_intolerancehttp://en.wikipedia.org/wiki/Endocrine_diseaseshttp://en.wikipedia.org/wiki/Kidney_diseaseshttp://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9http://en.wikipedia.org/wiki/Ophthalmoscopyhttp://en.wikipedia.org/wiki/Optic_fundushttp://en.wikipedia.org/wiki/Hypertensive_retinopathyhttp://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Syncope_%28medicine%29http://en.wikipedia.org/wiki/Tinnitushttp://en.wikipedia.org/wiki/Vertigohttp://en.wikipedia.org/wiki/Lightheadednesshttp://en.wikipedia.org/wiki/Occiputhttp://en.wikipedia.org/wiki/Headachehttp://en.wikipedia.org/wiki/Screening_%28medicine%29


5/16


2012


myocardial infarction) or sometimes aortic dissection, the tearing of the inner wall of the aorta.Breathlessness, cough, and the expectoration of blood-stained sputum are characteristic signs of

pulmonary edema, the swelling of lung tissue due to left ventricular failure an inability of the left

ventricle of the heart to adequately pump blood from the lungs into the arterial system. Rapid

deterioration of kidney function (acute kidney injury) and microangiopathic hemolytic anemia

(destruction of blood cells) may also occur. In these situations, rapid reduction of the bloodpressure is mandated to stop ongoing organ damage. In contrast there is no evidence that blood

pressure needs to be lowered rapidly in hypertensive urgencies where there is no evidence oftarget organ damage and over aggressive reduction of blood pressure is not without risks[11]Use

of oral medications to lower the BP gradually over 24 to 48 h is advocated in hypertensive

urgencies.

In pregnancy

Hypertension occurs in approximately 8-10% of pregnancies. Most women with hypertension inpregnancy have pre-existing primary hypertension, but high blood pressure in pregnancy may be

the first sign ofpre-eclampsia, a serious condition of the second half of pregnancy andpuerperium. Pre-eclampsia is characterized by increased blood pressure and the presence of

protein in the urine. It occurs in about 5% of pregnancies and is responsible for approximately

16% of all maternal deaths globally. Pre-eclampsia also doubles the risk ofperinatal mortality.[11]

Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. Whensymptoms of pre-eclampsia occur the most common are headache, visual disturbance (often

"flashing lights"), vomiting, epigastria pain, and edema. Pre-eclampsia can occasionally progress

to a life-threatening condition called eclampsia, which is a hypertensive emergency and hasseveral serious complications including vision loss, cerebral edema, seizures or convulsions,

renal failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting

disorder).

In infants and children

Failure to thrive, seizures, irritability, lackof energy, and difficulty breathing can be

associated with hypertension in neonates

and young infants. In older infants andchildren, hypertension can cause headache,

unexplained irritability, fatigue, failure to

thrive, blurred vision, nosebleeds, and

facial paralysis.

Complications

Hypertension is the most importantpreventable risk factor for premature death

worldwide. It increases the risk ofischemic

heart disease strokes, peripheral vascular disease, and other cardiovascular diseases, including
http://en.wikipedia.org/wiki/Myocardial_infarctionhttp://en.wikipedia.org/wiki/Aortic_dissectionhttp://en.wikipedia.org/wiki/Aortahttp://en.wikipedia.org/wiki/Dyspneahttp://en.wikipedia.org/wiki/Pulmonary_edemahttp://en.wikipedia.org/wiki/Left_ventricular_failurehttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Acute_kidney_injuryhttp://en.wikipedia.org/wiki/Acute_kidney_injuryhttp://en.wikipedia.org/wiki/Microangiopathic_hemolytic_anemiahttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Pre-eclampsiahttp://en.wikipedia.org/wiki/Puerperiumhttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/Perinatal_mortalityhttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Epigastrichttp://en.wikipedia.org/wiki/Edemahttp://en.wikipedia.org/wiki/Eclampsiahttp://en.wikipedia.org/wiki/Hypertensive_emergencyhttp://en.wikipedia.org/wiki/Blindnesshttp://en.wikipedia.org/wiki/Cerebral_edemahttp://en.wikipedia.org/wiki/Tonic-clonic_seizureshttp://en.wikipedia.org/wiki/Convulsionshttp://en.wikipedia.org/wiki/Renal_failurehttp://en.wikipedia.org/wiki/Pulmonary_edemahttp://en.wikipedia.org/wiki/Disseminated_intravascular_coagulationhttp://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Seizureshttp://en.wikipedia.org/wiki/Irritabilityhttp://en.wikipedia.org/wiki/Lethargyhttp://en.wikipedia.org/wiki/Lethargyhttp://en.wikipedia.org/wiki/Infant_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Fatigue_%28medical%29http://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Blurred_visionhttp://en.wikipedia.org/wiki/Epistaxishttp://en.wikipedia.org/wiki/Bell_palsyhttp://en.wikipedia.org/wiki/List_of_preventable_causes_of_deathhttp://en.wikipedia.org/wiki/Ischemic_heart_diseasehttp://en.wikipedia.org/wiki/Ischemic_heart_diseasehttp://en.wikipedia.org/wiki/Strokeshttp://en.wikipedia.org/wiki/Peripheral_vascular_diseasehttp://en.wikipedia.org/wiki/File:Main_complications_of_persistent_high_blood_pressure.svghttp://en.wikipedia.org/wiki/Peripheral_vascular_diseasehttp://en.wikipedia.org/wiki/Strokeshttp://en.wikipedia.org/wiki/Ischemic_heart_diseasehttp://en.wikipedia.org/wiki/Ischemic_heart_diseasehttp://en.wikipedia.org/wiki/List_of_preventable_causes_of_deathhttp://en.wikipedia.org/wiki/Bell_palsyhttp://en.wikipedia.org/wiki/Epistaxishttp://en.wikipedia.org/wiki/Blurred_visionhttp://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Fatigue_%28medical%29http://en.wikipedia.org/wiki/Infant_respiratory_distress_syndromehttp://en.wikipedia.org/wiki/Lethargyhttp://en.wikipedia.org/wiki/Lethargyhttp://en.wikipedia.org/wiki/Irritabilityhttp://en.wikipedia.org/wiki/Seizureshttp://en.wikipedia.org/wiki/Failure_to_thrivehttp://en.wikipedia.org/wiki/Disseminated_intravascular_coagulationhttp://en.wikipedia.org/wiki/Pulmonary_edemahttp://en.wikipedia.org/wiki/Renal_failurehttp://en.wikipedia.org/wiki/Convulsionshttp://en.wikipedia.org/wiki/Tonic-clonic_seizureshttp://en.wikipedia.org/wiki/Cerebral_edemahttp://en.wikipedia.org/wiki/Blindnesshttp://en.wikipedia.org/wiki/Hypertensive_emergencyhttp://en.wikipedia.org/wiki/Eclampsiahttp://en.wikipedia.org/wiki/Edemahttp://en.wikipedia.org/wiki/Epigastrichttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Perinatal_mortalityhttp://en.wikipedia.org/wiki/Maternal_deathhttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Puerperiumhttp://en.wikipedia.org/wiki/Pre-eclampsiahttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Microangiopathic_hemolytic_anemiahttp://en.wikipedia.org/wiki/Acute_kidney_injuryhttp://en.wikipedia.org/wiki/Acute_kidney_injuryhttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Left_ventriclehttp://en.wikipedia.org/wiki/Left_ventricular_failurehttp://en.wikipedia.org/wiki/Pulmonary_edemahttp://en.wikipedia.org/wiki/Dyspneahttp://en.wikipedia.org/wiki/Aortahttp://en.wikipedia.org/wiki/Aortic_dissectionhttp://en.wikipedia.org/wiki/Myocardial_infarction


6/16


2012


heart failure, aortic aneurysms, diffuse atherosclerosis, and pulmonary embolism. Hypertensionis also a risk factor for cognitive impairment and dementia, and chronic kidney disease. Other

complications include:

Hypertensive retinopathy Hypertensive nephropathy

Cause

Primary hypertensionPrimary (essential) hypertension is the most common form of hypertension, accounting for 9095% of all cases of hypertension. In almost all contemporary societies, blood pressure rises withaging and the risk of becoming hypertensive in later life is considerable. Hypertension results

from a complex interaction of genes and environmental factors. Numerous common genes with

small effects on blood pressure have been identified as well as some rare genes with large effectson blood pressure but the genetic basis of hypertension is still poorly understood. Several

environmental factors influence blood pressure. Lifestyle factors that lower blood pressure,

include reduced dietary salt intake, increased consumption of fruits and low fat products (Dietary

Approaches to Stop Hypertension (DASH diet)), exercise, loss and reduced alcohol intake. Thepossible role of other factors such as stress, caffeine consumption, and vitamin D deficiency are

less clear cut. Insulin resistance, which is common in obesity and is a component ofsyndrome X

(or the metabolic syndrome), is also thought to contribute to hypertension.[30]

Recent studies

have also implicated events in early life (for example low birth weight, maternal smoking andlack ofbreast feeding) as risk factors for adult essential hypertension, although the mechanisms

linking these exposures to adult hypertension remain obscure.

Secondary hypertensionSecondary hypertension results from an identifiable cause. Renal disease is the most common

secondary cause of hypertension.[11]

Hypertension can also be caused by endocrine conditions,

such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome orhyperaldosteronism, hyperparathyroidism and pheochromocytoma. Other causes of secondary

hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive

liquorice consumption and certain prescription medicines, herbal remedies and illegal drugs.

Typical tests performed in hypertensionSystem Tests

Renal Microscopic urinalysis, proteinuria, serum BUN (blood urea nitrogen)

and/or creatinine

Endocrine Serum sodium, potassium, calcium, TSH (thyroid-stimulating hormone).

Metabolic Fasting blood glucose, total cholesterol, HDL and LDL cholesterol,

triglycerides

Other Hematocrit, electrocardiogram, and chest radiograph
http://en.wikipedia.org/wiki/Heart_failurehttp://en.wikipedia.org/wiki/Aortic_aneurysmhttp://en.wikipedia.org/wiki/Atherosclerosishttp://en.wikipedia.org/wiki/Pulmonary_embolismhttp://en.wikipedia.org/wiki/Cognitive_impairmenthttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Chronic_kidney_diseasehttp://en.wikipedia.org/wiki/Hypertensive_retinopathyhttp://en.wikipedia.org/wiki/Hypertensive_nephropathyhttp://en.wikipedia.org/wiki/Aginghttp://en.wikipedia.org/wiki/Salthttp://en.wikipedia.org/wiki/DASH_diethttp://en.wikipedia.org/wiki/Exercisehttp://en.wikipedia.org/wiki/Alcoholic_beveragehttp://en.wikipedia.org/wiki/Insulin_resistancehttp://en.wikipedia.org/wiki/Metabolic_syndromehttp://en.wikipedia.org/wiki/Metabolic_syndromehttp://en.wikipedia.org/wiki/Hypertension#cite_note-pmid12364344-29http://en.wikipedia.org/wiki/Hypertension#cite_note-pmid12364344-29http://en.wikipedia.org/wiki/Hypertension#cite_note-pmid12364344-29http://en.wikipedia.org/wiki/Low_birth_weighthttp://en.wikipedia.org/wiki/Breast_feedinghttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Hyperthyroidismhttp://en.wikipedia.org/wiki/Hypothyroidismhttp://en.wikipedia.org/wiki/Acromegalyhttp://en.wikipedia.org/wiki/Conn%27s_syndromehttp://en.wikipedia.org/wiki/Hyperaldosteronismhttp://en.wikipedia.org/wiki/Hyperparathyroidismhttp://en.wikipedia.org/wiki/Pheochromocytomahttp://en.wikipedia.org/wiki/Obesityhttp://en.wikipedia.org/wiki/Sleep_apneahttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Coarctation_of_the_aortahttp://en.wikipedia.org/wiki/Liquoricehttp://en.wikipedia.org/wiki/Urinalysishttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Blood_urea_nitrogenhttp://en.wikipedia.org/wiki/Creatininehttp://en.wikipedia.org/wiki/Sodiumhttp://en.wikipedia.org/wiki/Potassiumhttp://en.wikipedia.org/wiki/Calciumhttp://en.wikipedia.org/wiki/Thyroid-stimulating_hormonehttp://en.wikipedia.org/wiki/Metabolichttp://en.wikipedia.org/wiki/Glucose_testhttp://en.wikipedia.org/wiki/High-density_lipoproteinhttp://en.wikipedia.org/wiki/LDLhttp://en.wikipedia.org/wiki/Triglycerideshttp://en.wikipedia.org/wiki/Hematocrithttp://en.wikipedia.org/wiki/Electrocardiogramhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Electrocardiogramhttp://en.wikipedia.org/wiki/Hematocrithttp://en.wikipedia.org/wiki/Triglycerideshttp://en.wikipedia.org/wiki/LDLhttp://en.wikipedia.org/wiki/High-density_lipoproteinhttp://en.wikipedia.org/wiki/Glucose_testhttp://en.wikipedia.org/wiki/Metabolichttp://en.wikipedia.org/wiki/Thyroid-stimulating_hormonehttp://en.wikipedia.org/wiki/Thyroid-stimulating_hormonehttp://en.wikipedia.org/wiki/Calciumhttp://en.wikipedia.org/wiki/Potassiumhttp://en.wikipedia.org/wiki/Sodiumhttp://en.wikipedia.org/wiki/Creatininehttp://en.wikipedia.org/wiki/Blood_urea_nitrogenhttp://en.wikipedia.org/wiki/Blood_urea_nitrogenhttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Urinalysishttp://en.wikipedia.org/wiki/Liquoricehttp://en.wikipedia.org/wiki/Coarctation_of_the_aortahttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Sleep_apneahttp://en.wikipedia.org/wiki/Obesityhttp://en.wikipedia.org/wiki/Pheochromocytomahttp://en.wikipedia.org/wiki/Hyperparathyroidismhttp://en.wikipedia.org/wiki/Hyperaldosteronismhttp://en.wikipedia.org/wiki/Conn%27s_syndromehttp://en.wikipedia.org/wiki/Acromegalyhttp://en.wikipedia.org/wiki/Hypothyroidismhttp://en.wikipedia.org/wiki/Hyperthyroidismhttp://en.wikipedia.org/wiki/Cushing%27s_syndromehttp://en.wikipedia.org/wiki/Hypertension#cite_note-ABC-10http://en.wikipedia.org/wiki/Breast_feedinghttp://en.wikipedia.org/wiki/Low_birth_weighthttp://en.wikipedia.org/wiki/Hypertension#cite_note-pmid12364344-29http://en.wikipedia.org/wiki/Metabolic_syndromehttp://en.wikipedia.org/wiki/Metabolic_syndromehttp://en.wikipedia.org/wiki/Insulin_resistancehttp://en.wikipedia.org/wiki/Alcoholic_beveragehttp://en.wikipedia.org/wiki/Exercisehttp://en.wikipedia.org/wiki/DASH_diethttp://en.wikipedia.org/wiki/Salthttp://en.wikipedia.org/wiki/Aginghttp://en.wikipedia.org/wiki/Hypertensive_nephropathyhttp://en.wikipedia.org/wiki/Hypertensive_retinopathyhttp://en.wikipedia.org/wiki/Chronic_kidney_diseasehttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Cognitive_impairmenthttp://en.wikipedia.org/wiki/Pulmonary_embolismhttp://en.wikipedia.org/wiki/Atherosclerosishttp://en.wikipedia.org/wiki/Aortic_aneurysmhttp://en.wikipedia.org/wiki/Heart_failure


7/16


2012


Hypertension is diagnosed on the basis of a persistently high blood pressure. Traditionally, thisrequires three separate sphygmomanometer measurements at one monthly interval. Initial

assessment of the hypertensive people should include a complete history and physical

examination. With the availability of 24-hour ambulatory blood pressure monitors and home

blood pressure machines, the importance of not wrongly diagnosing those who have white coat

hypertension has led to a change in protocols. In the United Kingdom, current best practice is tofollow up a single raised clinic reading with ambulatory measurement, or less ideally with home

blood pressure monitoring over the course of 7 days.

Once the diagnosis of hypertension has been made, physicians will attempt to identify the

underlying cause based on risk factors and other symptoms, if present. Secondary hypertension ismore common in preadolescent children, with most cases caused by renal disease. Primary or

essential hypertension is more common in adolescents and has multiple risk factors, including

obesity and a family history of hypertension. Laboratory tests can also be performed to identify

possible causes of secondary hypertension, and to determine whether hypertension has causeddamage to the heart, eyes, and kidneys. Additional tests for diabetes and high cholesterol levels

are usually performed because these conditions are additional risk factors for the development ofheart disease and require treatment.

Serum creatinine is measured to assess for the presence of kidney disease, which can be either

the cause or the result of hypertension. Serum creatinine alone may overestimate glomerularfiltration rate and recent guidelines advocate the use of predictive equations such as the

Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate

(eGFR). eGFR can also provide a baseline measurement of kidney function that can be used tomonitor for side effects of certain antihypertensive drugs on kidney function. Additionally,

testing of urine samples for protein is used as a secondary indicator of kidney disease.

Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain

from high blood pressure. It may also show whether there is thickening of the heart muscle (leftventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a

silent heart attack. A chest X-ray or an echocardiogram may also be performed to look for signs

of heart enlargement or damage to the heart.

What causes hypertension?

Though the exact causes of hypertension are usually unknown, there are several factors that havebeen highly associated with the condition. These include:

Smoking Obesity or being overweight Diabetes Sedentary lifestyle Lack of physical activity High levels of salt intake (sodium sensitivity) Insufficient calcium, potassium, and magnesium consumption Vitamin D deficiency High levels of alcohol consumption
http://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Chest_radiographhttp://en.wikipedia.org/wiki/Medical_historyhttp://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Ambulatory_blood_pressurehttp://en.wikipedia.org/wiki/Bloodpressure#home_monitoringhttp://en.wikipedia.org/wiki/Bloodpressure#home_monitoringhttp://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Renal_diseasehttp://en.wikipedia.org/wiki/Essential_hypertensionhttp://en.wikipedia.org/wiki/Human_hearthttp://en.wikipedia.org/wiki/Human_eyeshttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Diabeteshttp://en.wikipedia.org/wiki/Cholesterolhttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Creatininehttp://en.wikipedia.org/wiki/Glomerular_filtration_ratehttp://en.wikipedia.org/wiki/Glomerular_filtration_ratehttp://en.wikipedia.org/wiki/Modification_of_Diet_in_Renal_Diseasehttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Electrocardiogramhttp://en.wikipedia.org/wiki/Left_ventricular_hypertrophyhttp://en.wikipedia.org/wiki/Left_ventricular_hypertrophyhttp://en.wikipedia.org/wiki/Chest_X-rayhttp://en.wikipedia.org/wiki/Echocardiogramhttp://www.medicalnewstoday.com/info/obesity/how-much-should-i-weigh.phphttp://www.medicalnewstoday.com/info/diabetes/http://www.medicalnewstoday.com/articles/161618.phphttp://www.medicalnewstoday.com/articles/161618.phphttp://www.medicalnewstoday.com/info/diabetes/http://www.medicalnewstoday.com/info/obesity/how-much-should-i-weigh.phphttp://en.wikipedia.org/wiki/Echocardiogramhttp://en.wikipedia.org/wiki/Chest_X-rayhttp://en.wikipedia.org/wiki/Left_ventricular_hypertrophyhttp://en.wikipedia.org/wiki/Left_ventricular_hypertrophyhttp://en.wikipedia.org/wiki/Electrocardiogramhttp://en.wikipedia.org/wiki/Proteinuriahttp://en.wikipedia.org/wiki/Modification_of_Diet_in_Renal_Diseasehttp://en.wikipedia.org/wiki/Glomerular_filtration_ratehttp://en.wikipedia.org/wiki/Glomerular_filtration_ratehttp://en.wikipedia.org/wiki/Creatininehttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Cholesterolhttp://en.wikipedia.org/wiki/Diabeteshttp://en.wikipedia.org/wiki/Kidneyhttp://en.wikipedia.org/wiki/Human_eyeshttp://en.wikipedia.org/wiki/Human_hearthttp://en.wikipedia.org/wiki/Essential_hypertensionhttp://en.wikipedia.org/wiki/Renal_diseasehttp://en.wikipedia.org/wiki/Secondary_hypertensionhttp://en.wikipedia.org/wiki/Bloodpressure#home_monitoringhttp://en.wikipedia.org/wiki/Bloodpressure#home_monitoringhttp://en.wikipedia.org/wiki/Ambulatory_blood_pressurehttp://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Physical_examinationhttp://en.wikipedia.org/wiki/Medical_history


8/16


2012


Stress Aging Medicines such as birth control pills Genetics and a family history of hypertension Chronic kidney disease Adrenal and thyroid problems or tumors

Statistics in the USA indicate that African Americans have a higher incidence of hypertensionthan other ethnicities.

What are symptoms of hypertension?

There is no guarantee that a person with hypertension will present any symptoms of the

condition. About 33% of people actually do not know that they have high blood pressure, and

this ignorance can last for years. For this reason, it is advisable to undergo periodic bloodpressure screenings even when no symptoms are present.

Extremely high blood pressure may lead to some symptoms, however, and these include:

Severe headaches Fatigue or confusion Dizziness Nausea Problems with vision Chest pains Breathing problems Irregular heartbeat Blood in the urine

How is hypertension diagnosed?

Hypertension may be diagnosed by a health professional who measures blood pressure with adevice called a sphygmomanometer - the device with the arm cuff, dial, pump, and valve. The

systolic and diastolic numbers will be recorded and compared to a chart of values. If the pressure

is greater than 140/90, you will be considered to have hypertension.

A high blood pressure measurement, however, may be spurious or the result of stress at the time

of the exam. In order to perform a more thorough diagnosis, physicians usually conduct a

physical exam and ask for the medical history of you and your family. Doctors will need to know

if you have any of the risk factors for hypertension, such as smoking, high cholesterol, ordiabetes.

If hypertension seems reasonable, tests such as electrocardiograms (EKG) and echocardiogramswill be used in order to measure electrical activity of the heart and to assess the physical

structure of the heart. Additional blood tests will also be required to identify possible causes of
http://www.medicalnewstoday.com/articles/145855.phphttp://www.medicalnewstoday.com/articles/172179.phphttp://www.medicalnewstoday.com/releases/73936.phphttp://www.medicalnewstoday.com/releases/8877.phphttp://www.medicalnewstoday.com/articles/9152.phphttp://www.medicalnewstoday.com/articles/9152.phphttp://www.medicalnewstoday.com/releases/8877.phphttp://www.medicalnewstoday.com/releases/73936.phphttp://www.medicalnewstoday.com/articles/172179.phphttp://www.medicalnewstoday.com/articles/145855.php


9/16


2012


secondary hypertension and to measure renal function, electrolyte levels, sugar levels, andcholesterol levels.

Hypertension is the term used to describe high blood pressure.

Blood pressure is a measurement of the force against the walls of your arteries as your heartpumps blood through your body.

Blood pressure readings are usually given as two numbers -- for example, 120 over 80 (writtenas 120/80 mmHg). One or both of these numbers can be too high.

The top number is called the systolic blood pressure, and the bottom number is called the

diastolic blood pressure.

Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most ofthe time.

High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg orabove most of the time.

If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

If you have pre-hypertension, you are more likely to develop high blood pressure.

If you have heart or kidney problems, or if you had a stroke, your doctor may want your blood

pressure to be even lower than that of people who do not have these conditions.

Causes, incidence, and risk factors

Many factors can affect blood pressure, including:

How much water and salt you have in your body The condition of your kidneys, nervous system, or blood vessels The levels of different body hormones

You are more likely to be told your blood pressure is too high as you get older. This is because

your blood vessels become stiffer as you age. When that happens, your blood pressure goes up.

High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney

disease, and early death.

You have a higher risk of high blood pressure if you:

Are African American Are obese Are often stressed or anxious Drink too much alcohol (more than one drink per day for women and more than two

drinks per day for men)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/


10/16


2012


Eat too much salt in your diet Have a family history of high blood pressure Have diabetes Smoke

Most of the time, no cause of high blood pressure is found. This is called essential hypertension.

High blood pressure that is caused by another medical condition or medication is called

secondary hypertension. Secondary hypertension may be due to:

Chronic kidney disease Disorders of the adrenal gland (pheochromocytoma or Cushing syndrome) Pregnancy (see: preeclampsia) Medications such as birth control pills, diet pills, some cold medications, and migraine

medications

Narrowed artery that supplies blood to the kidney (renal artery stenosis) Hyperparathyroidism

Symptoms

Most of the time, there are no symptoms. For most patients, high blood pressure is found whenthey visit their health care provider or have it checked elsewhere.

Because there are no symptoms, people can develop heart disease and kidney problems without

knowing they have high blood pressure.

If you have a severe headache, nausea or vomiting, bad headache, confusion, changes in your

vision, or nosebleeds you may have a severe and dangerous form of high blood pressure calledmalignant hypertension.

ABC MODEL:

A major aid in cognitive therapy is what Albert Ellis called the ABC Technique of IrrationalBeliefs[2]. The first three steps analyze the process by which a person has developed irrational

beliefs and may be recorded in a three-column table.

A. Activating Event or objective situation. The first column records the objective situation,that is, an event that ultimately leads to some type of high emotional response or negative

dysfunctional thinking.B. Beliefs. In the second column, the client writes down the negative thoughts that occurred

to them.

C. Consequence. The third column is for the negative feelings and dysfunctional behaviorsthat ensued. The negative thoughts of the second column are seen as a connecting bridgebetween the situation and the distressing feelings. The third column C is next explained
http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A002415/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000471/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000340/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000410/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000898/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000204/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001215/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000491/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000491/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A001215/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000204/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000898/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000410/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000340/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000471/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A002415/


11/16


2012


by describing emotions or negative thoughts that the client thinks are caused by A. Thiscould be anger, sorrow, anxiety, etc.

For example, Gina is upset because she got a low mark on a math test. The Activating event, A,

is that she failed her test. The Belief, B, is that she must have good grades or she is worthless.The Consequence, C, is that Gina feels depressed.

After irrational beliefs have been identified, the therapist will often work with the client in

challenging the negative thoughts on the basis of evidence from the client's experience byreframing it, meaning to re-interpret it in a more realistic light. This helps the client to develop

more rational beliefs and healthy coping strategies.

From the example above, a therapist would help Gina realize that there is no evidence that she

must have good grades to be worthwhile, or that getting bad grades is awful. She desires good

grades, and it would be good to have them, but it hardly makes her worthless. If she realizes thatgetting bad grades is disappointing, but not awful, and that it means she is currently bad at math

or at studying, but not as a person, she will feel sad or frustrated, but not depressed. The sadness

and frustration are likely healthy negative emotions and may lead her to study harder from thenon.

Another way of viewing the ABC's of Cognitive Behavioral Therapy

A. Activating Stimulus this is the stimulus that activates the irrational fear or anxiety in theperson.

B. Blank this is the blank process that lies in between the stimulus and the irrationalthinking. The person would have to identify this gap and create a bridge in their thoughtprocess in order to be able to be treated.

C. Conditioned Response this is the irrational fear or anxiety with which the person hasconditioned them to respond with to the stimulus.

The way the treatment works is that by going back and thinking over what the stimulus was and

the irrational reaction to it and then try to follow the chain events that led from one to another,thereby filling in the blank in between, the person can identify what causes their thinking to

become irrational.

For example;

A person walks out of his home and hears an ambulance siren. The person gets anxious from thisand runs back into his home. The Activating Stimulus was the ambulance siren. The Conditioned

Response was severe anxiety and running into his home. The person now has to fill in the Blank

and try to understand what was the exact thought process that went through his mind that causedthe irrational response to take place. By bridging this gap in his thought, he is identifying the

faulty thought process that caused the extreme response. The person can now work on replacing


12/16


2012


these faulty thoughts with realistic ones, thereby correcting the undesired chain of thoughts andactivating a functional one.

Antecedents Behaviors Consequences

Actions:

Emotions:

Characteristics to behavior modification:

Behavior modification is the use of empirically demonstrated behavior change techniques toincrease or decrease the frequency of behaviors, such as altering an individual's behaviors and

reactions to stimuli through positive and negative reinforcement ofadaptive behavior and/or the

reduction of behavior through its extinction, punishment and/or satiation. Most behaviormodification programs currently used are those based on applied behavior analysis (ABA),

formerly known as the experimental analysis of behavior which was pioneered by B. F. Skinner.

Description

The first use of the term behavior modification appears to have been by Edward Thorndike in

1911. His article Provisional Laws of Acquired Behavior or Learning makes frequent use of the

term "modifying behavior". Through early research in the 1940s and the 1950s the term was usedby Joseph Wolpe's research group. The experimental tradition in clinical psychology used it to

refer to psycho-therapeutic techniques derived from empirical research. It has since come to refer

mainly to techniques for increasing adaptive behavior through reinforcement and decreasingmaladaptive behavior through extinction or punishment (with emphasis on the former). Two

related terms are behavior therapy and applied behavior analysis. Emphasizing the empirical

roots of behavior modification, some authors consider it to be broader in scope and to subsumethe other two categories of behavior change methods. Since techniques derived from behavioral

psychology tend to be the most effective in altering behavior, most practitioners consider

behavior modification along with behavior therapy and applied behavior analysis to be founded

in behaviorism. While behavior modification encompasses applied behavior analysis and

typically uses interventions based on the same behavioral principles, many behavior modifierswho are not applied behavior analysts tend to use packages of interventions and do not conduct

functional assessments before intervening.

In recent years, the concept ofpunishment has had many critics, though these criticisms tend not

to apply to negative punishment (time-outs) and usually apply to the addition of some aversive

event. The use of positive punishment by board-certified behavior analysts is restricted toextreme circumstances when all other forms of treatment have failed and when the behavior to
http://en.wikipedia.org/wiki/Behavioral_change_theorieshttp://en.wikipedia.org/wiki/Reinforcementhttp://en.wikipedia.org/wiki/Adaptive_behaviorhttp://en.wikipedia.org/wiki/Extinction_%28psychology%29http://en.wikipedia.org/wiki/Punishmenthttp://en.wikipedia.org/wiki/Applied_behavior_analysishttp://en.wikipedia.org/wiki/Experimental_analysis_of_behaviorhttp://en.wikipedia.org/wiki/B._F._Skinnerhttp://en.wikipedia.org/wiki/Edward_Thorndikehttp://en.wikipedia.org/wiki/Joseph_Wolpehttp://en.wikipedia.org/wiki/Behavior_therapyhttp://en.wikipedia.org/wiki/Applied_behavior_analysishttp://en.wikipedia.org/wiki/Behaviorismhttp://en.wikipedia.org/wiki/Punishment_%28psychology%29http://en.wikipedia.org/wiki/Punishment_%28psychology%29http://en.wikipedia.org/wiki/Behaviorismhttp://en.wikipedia.org/wiki/Applied_behavior_analysishttp://en.wikipedia.org/wiki/Behavior_therapyhttp://en.wikipedia.org/wiki/Joseph_Wolpehttp://en.wikipedia.org/wiki/Edward_Thorndikehttp://en.wikipedia.org/wiki/B._F._Skinnerhttp://en.wikipedia.org/wiki/Experimental_analysis_of_behaviorhttp://en.wikipedia.org/wiki/Applied_behavior_analysishttp://en.wikipedia.org/wiki/Punishmenthttp://en.wikipedia.org/wiki/Extinction_%28psychology%29http://en.wikipedia.org/wiki/Adaptive_behaviorhttp://en.wikipedia.org/wiki/Reinforcementhttp://en.wikipedia.org/wiki/Behavioral_change_theories


13/16


2012


be modified is a danger to the person or to others (see professional practice of behavior analysis).In clinical settings positive punishment is usually restricted to using a spray bottle filled with

water as an aversive event. When misused, more aversive punishment can lead to affective

(emotional) disorders, as well as to the receiver of the punishment increasingly trying to avoid

the punishment (i.e., "not get caught").

Martin and Pear indicate that there are seven characteristics to behavior modification, they are:

There is a strong emphasis on defining problems in terms of behavior that can bemeasured in some way.

The treatment techniques are ways of altering an individual's current environment to helpthat individual function more fully.

The methods and rationales can be described precisely. The techniques are often applied in everyday life. The techniques are based largely on principles of learning

specifically operant conditioning and respondent conditioning

There is a strong emphasis on scientific demonstration that a particular technique wasresponsible for a particular behavior change.

There is a strong emphasis on accountability for everyone involved in a behaviormodification program

Behavior Modification Techniques:

Behavior is the way a person reacts to a particular stimulus and varies from individual to

individual. Behavior modification technique is the way you improve the behavior of a person,

through use of some positive and negative reinforcements and punishments. It is the process ofaltering a persons reaction to stimuli. Behavior modification is much used in clinical andeducational psychology, particularly in case of people with learning difficulties. In the day to day

life, it is mostly used in the classroom scenario, where the teachers use such techniques to reformthe behavior of a child. Read on to know more about techniques used for modifying behavior.

Stages of Behavior Modification

Behavior modification is based on two types of theories. One involves antecedents i.e. events

which occur before a particular behavior is demonstrated and the other is observable behavior i.e.

those events that occur after a particular behavior has been occurred. A behavior modification

technique is applicable only after a series of changes. An inappropriate behavior is observed,identified, targeted, and stopped. Meanwhile, a new, appropriate behavior must be identified,

developed, strengthened, and maintained.

Reinforcements and PunishmentPositive reinforcements are the ways in which you encourage the desired behavior. It increases

the future frequency of the desired behavior. Patting the back, passing a smile or sometimes even

giving a chocolate when a person behaves properly is called positive reinforcement. Negative
http://en.wikipedia.org/wiki/Professional_practice_of_behavior_analysishttp://en.wikipedia.org/wiki/Operant_conditioninghttp://en.wikipedia.org/wiki/Respondent_conditioninghttp://en.wikipedia.org/wiki/Respondent_conditioninghttp://en.wikipedia.org/wiki/Operant_conditioninghttp://en.wikipedia.org/wiki/Professional_practice_of_behavior_analysis


14/16


2012


reinforcement, on the other hand, increases the likelihood that a particular negative behaviorwould not happen in the future. It is often confused with punishment. While punishment is

negative, negative reinforcement is positive. It is a positive way of reducing a particular

behavior.

Behavior Modification Techniques

Classroom Monitoring: Effective teaching practices, frequent monitoring, strict rules andregulations, social appraisal, etc

Pro-social Behavior: Positive and negative reinforcements , modeling of pro-socialbehavior, verbal instruction, role playing, etc

Moral Education: Moral Science classes on real-life situations, imaginary situations andliterature. Let students play different roles as a teacher, principal, parents, etc and

participate in school administration.

Social Problem Solving (SPS): Direct teaching of SPS skills (e.g. alternative thinking,means-ends thinking), dialoguing, self-instruction training, etc

Effective Communication Models: Values explanation activities, active listening,importance of communication and interpersonal skills, training for students and teachers

Many professionals who dispense parenting advice tell parents to use rewards or create "behavior

modification" token systems to teach children a skill, to get children to take on a responsibility,

or to curb an unwanted behavior or habit. Often, however, rewarding good behavior withbehavior charts has the same effect as bribery.

Long-term studies of work incentives, behavior management programs for children, weight lossand stop smoking plans have all found similar, revealing results:

Performance and quality of work declines over time because people are thinking only about theincentive or reward, instead of the value of what they are doing.

If there is a loss of interest in the reward, people become less motivated to do the task?

The work becomes an unpleasant task that is endured strictly to get the reward.

People try to take short cuts to find the easiest way to finish the task, ratherthan challenging

themselves to do the best job possible.

Change is short-term. When the incentives are gone, so is the motivation for doing the task.

B.F. Skinner, the father ofbehavior modification sciences, made a name for himself with his

scientific research of the 1950's. He trained rats (and children later on), to repeat certain behaviorby rewarding them for desired behavior and withholding rewards or applying punishment for
http://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/diet.htmlhttp://www.selfgrowth.com/motivation.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/motivation.htmlhttp://www.selfgrowth.com/diet.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.htmlhttp://www.selfgrowth.com/behavior_modification.html


15/16


2012


poor behavior. His theories and practices have greatly influenced schools and psychologists foryears.

Recently, B.F. Skinner himself has recanted some of his own earlier conclusions. He realizedthat rewards work well on rats, but humans have deeper motivations. He also lived long enough

to see the negative long-term results of "conditioned responses."After producing a generation of young adults who expect rewards for every little

accomplishment, it is becoming obvious that creating such expectations and dependency isneither healthy nor realistic.

In several of my other articles (see list below), I share many ideas for motivating children to

cooperate without resorting to bribery. However, you might choose to use a behavior chart

anyway. If so, here are some suggestions for using behavior charts with fewer negative long-term

consequences (although there will always be some):

Promote internal competitiveness (doing one's best) ratherthan competing against others.

Competition destroys teamwork and damages relationships. This especially applies to siblings.

Make the tasks challenging, with a chance to learn new things. Explain the task in a way that

makes it a meaningful contribution which will improve the family or person.

Involve the people who will be using the charts in developing the charts. With children, usecreative ideas, like gluing pictures of tasks, to make this a fun project.

Have "rewards" be extra privileges or non-monetary bonuses, such as picking the place for aweekly family outing, having a friend overnight, extra time out on Friday night, choosing afamily game or video, or choosing the dinner menu and helping cook it.

Gradually phase out the chart as children learn new skills are reformhabits. Wean children

from rewards before they become addictive. Increase internal motivators through descriptive

encouragement.

Use the charts as reminders of agreements, not a record of rewards or payoffs. Focus on the

child's accomplishments instead of giving demerits for poor performance.

When children accomplish something new or improve their behavior voluntarily, they feel a

sense of self-respect that no sticker, candy, money, or reward can give them. Help children

understand the value behind the changes you ask them to make and help them take responsibility

for making those changes -- to feel better about themselves, not just to please you.
http://www.selfgrowth.com/family.htmlhttp://www.selfgrowth.com/family.htmlhttp://www.selfgrowth.com/family.htmlhttp://www.selfgrowth.com/habits.htmlhttp://www.selfgrowth.com/habits.htmlhttp://www.selfgrowth.com/habits.htmlhttp://www.selfgrowth.com/family.htmlhttp://www.selfgrowth.com/family.htmlhttp://www.selfgrowth.com/family.html


16/16


2012


Days Antecedents Behaviors Techniques

Day 1st

Day 2nd

Day 3rd

Day 4th

Day 5th

Day 6th

Day 7th

Day 8th

Day 9th

Day 10th

bad behavior hypertension

Documents