Which of the following is/are correct with reference to hypertension?

1. Age, sex, genetic factors, ethnicity are Non-modifiable risk factors
2. Obesity, high salt intake, saturated fat, dietary fiber, stress are modifiable risk factors
3. Hypertension is an iceberg disease.

Choose the most appropriate answer from the options given below:

1. A

   Only 2

2. B

   Only 1

3. C

   Only 1 and 2

4. D

   1, 2 and 3

Appeared in: Raj. CHO -2024

Explanation

• All three statements are factually correct regarding the risk factors and nature of hypertension.
• Statement 1 correctly identifies age, sex, genetics, and ethnicity as factors that an individual cannot change (non-modifiable).
• Statement 2 accurately lists obesity, diet (salt, fat, fiber), and stress as lifestyle-related factors that can be altered to manage blood pressure (modifiable).
• Statement 3 correctly applies the 'iceberg disease' concept to hypertension, where a large proportion of cases in the community are undiagnosed and asymptomatic, representing the hidden part of the iceberg.

Why Other Options Were Wrong

• Option A: This option is incomplete. While statement 2 is correct, statements 1 and 3 are also correct descriptions related to hypertension.
• Option B: This option is incomplete. Although statement 1 is correct, statements 2 and 3 are also correct.
• Option C: This option is incomplete. While statements 1 and 2 are correct, statement 3, which describes hypertension as an iceberg disease, is also a key epidemiological concept for this condition.

Related Visual

• Visual 1: Infographic: A visual chart separating modifiable and non-modifiable risk factors for hypertension.
• Visual 2: Diagram: An illustration of the 'Iceberg Phenomenon' showing the visible tip (diagnosed cases) and the large submerged base (undiagnosed/asymptomatic cases).

Clinical Relevance

• Nursing practice connection: Knowing Risk factors and epidemiological characteristics of hypertension helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Understanding risk factors is fundamental for nurses in patient education and primary prevention of hypertension.
• Nurses play a key role in screening for hypertension (the 'iceberg' part) and counseling patients on lifestyle modifications for the modifiable risk factors.
• The 'iceberg' concept reinforces the need for opportunistic screening in all clinical settings, as many patients will be asymptomatic.

How to Approach the Question

• First, evaluate each statement independently for its factual accuracy.
• Statement 1: Recall or verify the definition of non-modifiable risk factors and check if the examples (age, sex, genetics, ethnicity) fit this category.
• Statement 2: Recall or verify the definition of modifiable risk factors and confirm if the examples (obesity, diet, stress) are things that can be changed.
• Statement 3: Understand the epidemiological concept of an 'iceberg disease' (many hidden cases vs. few visible ones) and determine if it applies to a condition like hypertension, which is often asymptomatic.
• After evaluating all three statements, select the option that correctly reflects which of them are true. In this case, all three are correct.

Concept Tested & Keywords

• Concept Tested: Risk factors and epidemiological characteristics of hypertension.
• Stem keywords: hypertension, Non-modifiable risk factors, modifiable risk factors, iceberg disease
• Lead-in keywords: correct with reference to

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