The most recent American College of Cardiology/ American Heart Association clinical practice guidelines define hypertension as systolic BP greater or equal to 130 mmHg or diastolic BP greater or equal to 80 mmHg. Patients are then classified as having either stage 1 or stage 2 hypertension. Stage 2 usually requires medication in addition to lifestyle modifications to control blood pressure. If the diastolic and systolic blood pressure readings fall into different classifications, the higher classification is used. To make a clinical diagnosis of hypertension, two or more blood pressure readings obtained over two or more visit must fall into a particular classification (but not during acute illness or pain).
Considered to be the largest organ system in the human body, our skin protects our internal organs and structures. The skin layers include the epidermis, dermis, and subcutaneous tissue. Although skin is only 1 to 2 mm thick, it contains 15% of the total weight for an adult and acts as the first line of defense against invading microorganisms.
Providing protection for the underlying tissues and organs.
Receptors in the skin sense pain, pressure, and temperature changes.
Skin also plays a role in fluid balance, temperature regulation, and the synthesis of vitamin D.
The subcutaneous fatty layer acts as a cushion and stores fat for energy.
Alteration in skin integrity:
Age – As a person ages, physiological changes inherent to the aging process occur, such as reduced elasticity, loss of skin turgor, and decreased vascularity. Changes also occur in the cells at the junction of the dermis and epidermis, which may result in skin tearing more easily in elderly. Patients with a terminal illness pose a unique risk of alternations in skin integrity, and one aspect gaining attention includes the concept that skin injuries for these patient may be unavoidable and related to dying process.