Epidemiology Project Paper: Proposal for Change

Epidemiology Project Paper: Proposal for Change

For my epidemiological study, I would like to focus on Hypertension with an age category of 65-85 on how to prevent heart disease related to hypertension. I will attach the instructions and syllabus. Please contact me with any questions.

Problem identification with data support

In the current past, the health field in relation to health professionals has been putting efforts in the detection, prevention, and treatment of high blood pressure, even though the effort’s, hypertension remains as a major public health challenge. According to research, the hypertension condition approximately affects 50 million individuals in the United States (Merai et al., 2016). More so, epidemiological studies have revealed the presence of a strong connection between coronary artery disease (CAD) and hypertension. In this case, hypertension act as a basic risk factor for the emergence of other diseases such as renal failure, stroke, and CAD. This journal focuses on hypertension to individuals aged 65-85 and the connection on how to prevent heart-related hypertension. Epidemiology Project Paper: Proposal for Change.


Hypertension is primarily one of the risk factors that lead to the development of the cardiovascular disease (Petrie, Guzik & Touyz, 2018). The condition severity and prevalence are directly proportional to an increase in the age factor. According to the United States National Health and Nutrition Examination Survey reveals that 70% of the adults between 65-85 years have hypertension. Despite being liked to high preference and severity of hypertension and cardiovascular morbidity, aged adults regularly get undertreatment for such illnesses like blood pressure (BP). Also, this group of people face under presentation in clinical care since they are vulnerable to falling risk, autonomic dysfunction, poor renal function, and cognitive impairment. Besides, there is no chronological set cut off for defining older patients for administration of BP, making the process remain controversial.

Determinants of the issue with literature support

According to research, it is revealed that human blood vessels get naturally hardened as age increase, thus losing their normal elasticity (Niu et al., 2019). This may be one of the determinants that put people aged 65-85 years in high probabilities of suffering from high blood pressure. Besides, there are other risk factors that attract hypertensive condition to older adults. Such risk factors include obesity, diabetes, and kidney disease. For instance, it is revealed that there is a relationship between body mass and hypertension, whereas both factors are strongly interrelated with CAD. According to a study, an increase in body mass index together with age it leads to increase in blood pressure, thereby attracting the development of hypertension (Puzserova & Bernatova, 2016). Diabetes has a close relation to obesity, also acting as a major contributor to high blood pressure to older individuals. Also, kidney disease is a leading factor that causes blood pressure. Kidney disease leads to damaging of blood vessels in the kidney thus hindering the removal of waste materials. This instance may lead to inserting more pressure in the arteries, thereby developing hypertension.

Stakeholder input (based on a real conversation)

The epidemiology project involved making an extra step on reaching out significant stakeholder to conduct interviews and group discussion. Epidemiology Project Paper: Proposal for Change. Based on a real conversation with stakeholders, the process involved conducting consultation workshops to the ministry of health officials, healthcare providers, family members, community members, and actively involving patients (O’Hara et al., 2017). The process of meeting with stakeholders was conducted with a series of regular meetings as per every department. During the course, the project members presented an evidence-based involvement solution that every sector identified from all the other components (White, Todak & Gaub, 2018).

Intervention with literature support

Non-pharmacology interventions will aid the process of creating a hypertensive condition, and therefore this therapy should be put in practice for proper treatment (Caskey, 2019). For instance, the intervention campaign for hypertension includes weight control, physical activities, stress reduction, smoking cessation, and avoiding excessive alcoholism. As well, a proper diet intervention will help in treating hypertension. In this case, patients are advised to feed on a diet with low carbohydrates, plant-based, and being vegetarian. Also, behavioural therapies are included, such as biofeedback, yoga, Taiichi, and transcendental meditation are also some of the treatment therapies for hypertension. To the elderly, it will be important in lowering the level of sodium intake and managing weight since these are safe ways of improving blood pressure.

Pharmacological intervention of treating hypertension condition to the older adults are employed with consideration of factors such as comorbidities, ability to follow medical instructions, and supporting care members (American Diabetes Association, 2019). Application of angiotensin‐converting‐enzyme inhibitor (ACEI), calcium channel blocker (CCB), and Thiazide diuretics have shown a positive patient outcome mostly to the patient between 65-85 years. Notably, beta-blockers should not be administered to a patient over 60 years unless clinically advised since they may worsen the patient outcome. Before starting any medication, assessment should be done of orthostatic hypotension in order to gauge gradual titration based on the patient’s tolerance. Epidemiology Project Paper: Proposal for Change.

Evaluation (process & outcome)

The project proposal evaluation is an essential step that shows the need to increase the development and implementation of hypertension interventions (Correia et al., 2019). To measure the applicability, it involves the engagement of all key stakeholders through the process. Also, the team could measure the outcome by statistically evaluating the number of patient suffering from hypertension applying interventions appropriately. More so, clinicians should ensure regular check-ups are done for early detection of hypertension to individual aged 65-85 years this will significantly lower incidences of cardiovascular diseases (Kline et al., 2018).


American Diabetes Association. (2019). 12. Older adults: standards of medical care in diabetes—2019. Diabetes Care42(Supplement 1), S139-S147.

Caskey, T. J. (2019). What Is the Role of Non-pharmacotherapy in the Treatment of Depression with Cardiovascular Disease? (Doctoral dissertation, University of Bridgeport).

Correia, J. C., Lachat, S., Lagger, G., Chappuis, F., Golay, A., & Beran, D. (2019). Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low-and middle-income countries: a scoping review. BMC public health19(1), 1-20.

Kline, A. D., Moss, J. F., Selicorni, A., Bisgaard, A. M., Deardorff, M. A., Gillett, P. M., … & Ramos, F. J. (2018). Diagnosis and management of Cornelia de Lange syndrome: first international consensus statement. Nature Reviews Genetics19(10), 649-666.

Merai, R., Siegel, C., Rakotz, M., Basch, P., Wright, J., Wong, B., & Thorpe, P. (2016). CDC grand rounds: a public health approach to detect and control hypertension. Morbidity and mortality weekly report65(45), 1261-1264.

Niu, Z., Wang, X., Meng, X., Guo, X., Jiang, Y., Xu, Y., … & Shen, C. (2019). Controllable fiber orientation and nonlinear elasticity of electrospun nanofibrous small diameter tubular scaffolds for vascular tissue engineering. Biomedical Materials14(3), 035006.

O’Hara, M. C., Cunningham, Á., Keighron, C., Allen, G., Caulfield, A., Duffy, C., … & Simkin, S. (2017). Formation of a type 1 diabetes young adult patient and public involvement panel to develop a health behaviour change intervention: the D1 Now study. Research Involvement and Engagement3(1), 21.

Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms. Canadian Journal of Cardiology34(5), 575-584. Epidemiology Project Paper: Proposal for Change.

Puzserova, A., & Bernatova, I. (2016). Blood pressure regulation in stress: focus on nitric oxide-dependent mechanisms. Physiological research65.

White, M. D., Todak, N., & Gaub, J. E. (2018). Examining body‐worn camera integration and acceptance among police officers, citizens, and external stakeholders. Criminology & public policy17(3), 649-677.

Epidemiology of Hypertension in Older Adults between 65 and 85 Years Old

Hypertension is a growing public health concern among older adults in the developed world. Incidences of hypertension increase with age and become significantly high between the ages of 65 and 85.  Hypertensive adults in this age bracket are also at risk of a variety of coronary diseases, including heart disease. The management dilemma hypertension in older adults presents enormous challenges, thus necessitating preventive measures to reduce the burden of the condition (Buford, 2017). Studies have revealed that at least 70% of the population will develop hypertension at 65-85 years of age (Buford, 2017). About 75% of women above the age of 70 have hypertension and 65% for men above 70 years old. Recent research has revealed that treating hypertension in older adults significantly reduces chances of hypertension-related heart disease. The proposal focuses on the importance of preventing hypertension from reducing incidences of heart disease-related hypertension in patients between the ages of 65 and 85.

Factors that Contribute to Hypertension in Older Adults

Prevention of hypertension in older adults presents a major challenge since the condition is often asymptomatic (Buford, 2017). Several factors explain the prevalence of hypertension in older adults. These include arterial stiffness, autonomic and neurohormonal dysregulation, mechanical hemodynamic changes, and the ageing kidney (Oliveros et al., 2020). Advancing age results in functional and structural changes in the arterial system, which in turn stiffens the arteries causing difficulties in the cardiac process. Arterial stiffness is often a determinant for either ventricular dysfunction or cardiovascular disease. Mechanical hemodynamic changes reduce the elasticity of the aorta, thus accelerating hypertension (Oliveros et al., 2020). Autonomic and neurohormonal issues spike chemicals such as endothelin-1, aldosterone, and peripheral plasma norepinephrine in the cardiac system reducing cardiac responsiveness between the ages of 65 and 85 (Oliveros et al., 2020). Epidemiology Project Paper: Proposal for Change.

Input from Key Stakeholders

Stakeholders agree that hypertension is the most prevalent yet modifiable condition among older adults. Despite posing a substantial threat to public health in the US, hypertension is yet to efforts and input it warrants concerning research and prevention approaches (Milani et al., 2016). Key stakeholders, including medical practitioners, agree that lifestyle modification is the most applicable and inexpensive approach towards the prevention of hypertension and subsequent conditions in ageing patients. Having analyzed the state of affairs of hypertension and other related health conditions, it is clear that the condition is neglected and does not receive the corresponding allocation of revenue (Pierce, 2017). The government and policymakers have thus failed at addressing the public health concern (Milani et al., 2016). Although efforts towards hypertension prevention are dramatical, the CDC continues to channel efforts towards its cardiovascular disease program.

Intervention and Rationale

            There is limited literature on hypertension in older adults owing to the economic constraints surrounding the public health concern (Milani et al., 2016). The most feasible approach towards the prevention and management of hypertension and related cardiovascular disease is the patient-centred medical home (PCMH) care model. The approach proposes a patient-oriented rather than a general approach towards hypertension and the related conditions. Studies reveal that medical personnel have successfully applied the PCMH care model in controlling approximately 44% of hypertensive patients (O’Donnell et al., 2016). The approach is designed to ease patient-provider tension and includes their family in the prevention and management of the condition. The use of electronic health records alongside the PCMH care model has been successful in reducing health costs and improving patient outcomes (O’Donnell et al., 2016). Recent studies reveal that lifestyle changes from sedentary to physically active lifestyles are a great intervention in the prevention of hypertension. The adherence to protocols and guidelines from professional cardiac and other medical practitioners will also go a long way in the prevention of hypertension and hypertension-related heart disease among the older population.


            The biggest drawback towards the prevention and management of hypertension in older adults is the often asymptomatic nature of the condition. It is thus important for clinicians to pay attention to the finer details surrounding the risk factors for hypertension and related cardiovascular disease (Pierce, 2017). Research by the National Health and Nutrition Examination Survey revealed that routine medical checkups could come in handy in the prevention of cardiac disease related to hypertension in the older US population. Extensive studies on lifestyle-related factors and hypertension-related heart disease are also critical towards progressive research (Buford, 2017). Epidemiology Project Paper: Proposal for Change. C linicians must thus ensure intensive checkups to diagnose and treat hypertension hence reduce incidences of related cardiovascular disease.


            Hypertension is a medical condition that is characterized by dramatically high blood pressure levels. The prevalence of the condition rises with advancing age and is thus highest in older adults between the ages of 65 and 85. Hypertension is linked to various conditions in old age, including cardiovascular disease. The condition is the most adjustable yet most ignored, particularly in advanced age populations. Researchers have proposed various interventions towards the prevention of hypertension-related heart disease, including timely diagnosis and proper treatment of the condition.


Buford, T. W. (2017). Hypertension and aging. Ageing research reviews26, 96-111.

Milani, R. V., Lavie, C. J., Wilt, J. K., Bober, R. M., & Ventura, H. O. (2016). New concepts in hypertension management: a population-based perspective. Progress in cardiovascular diseases59(3), 289-294.

Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology43(2), 99-107.

Pierce, G. L. (2017). Aortic stiffness in aging and hypertension: prevention and treatment with habitual aerobic exercise. Current hypertension reports19(11), 90.


Epidemiology Project Paper: Proposal for Change

The purpose of the Epidemiology Project is to identify and research the extent of a selected problem within a community, as it compares with state and national data. In addition, you will use current evidence to support interventions for a selected population.

Write a 3- to 5-page Proposal for Change targeting a person or group that may have the power to implement your intervention (for example, legislators, health department directors, or school principals). Epidemiology Project Paper: Proposal for Change.

Include at least 2 references for each section that asks for literature support. These should be professional references with at least one original research study. Data support for the problem must also be referenced.

Note: This is a two-part assignment that includes a formal written paper (Proposal for Change, at 20% of your grade) and the visual scientific poster (15% of your grade).

Review the following documents for details in completing the Proposal for Change:

To begin writing the Proposal for Change you will need to do the following:

Investigate and identify a problem or issue in your community or county.

Research the factors that contribute to this issue (determinants) and interventions that have proven effective in addressing this issue.

Talk to key stakeholders in your community about what is currently being done to target the problem, resources that are available, and issues or areas for improvement they have identified.

Identify gaps or areas of improvement, and design 1 intervention that addresses or fills a gap.


Include the following:

Data showing there is a problem in the identified community.

Determinants or factors that impact the issue (literature supported).

Input from key stakeholders (you must interview people who are concerned about the issue).

Brief description of intervention and rationale (literature supported). Epidemiology Project Paper: Proposal for Change.