Final English!!!!

PREVENTION AND TREATMENT OF HYPERTENSION IN ADULT PATIENTS

A Research Paper In Partial Fulfillment of the Requirement in English 102 – Advanced Composition

Submitted by: Ma. Kristal Gale Aldemita Karla Charmaine Barrameda Mylene Refuerzo Jackylin Tan

Submitted to: Ms. Lina Hervas Professor

TRINITY UNIVERSITY OF ASIA March 2008

TABLE OF CONTENTS PAGE Approval sheet…………………………………………………………………………i Abstract.......................................................................................................................ii Acknowledgement ……………………………………………………………………iii

I.

INTRODUCTION Background…………………………………………………..…………………….1 Statement of the Problem…………………………………………………………..2 Scope and delimitation……………………………………………………………..3 Significance of the Study…………………………………………………………..3 Definition of terms…………………………………………………………………4

II.

COLLECTION OF READINGS Local literature…………………………………………………………………..….5 Foreign literature…………………………………………………………………….7 Relevance of the study……………………………………………………….…….10

III.

SUMMARY, CONCLUSION, RECOMMENDATIONS…………………….…..12

IV.

Bibliography……………………………………………………………………….. 13

V.

Resume ……………………………………………..…………………………...… 16

APPROVAL SHEET

This research, entitled Prevention and Treatment of Hypertension in Adult Patients, prepared by Ma. Kristal Gale S. Aldemita, Karla Charmaine P. Barrameda, Mylene B. Refuerzo and Jackylin L. Tan, in fulfillment of the requirements in English 102- A Advanced Composition and submitted to the department of English and Foreign Languages is hereby accepted.

_________________________________ Ms. Lina Hervas Professor

Acknowledgement

We would like to thank the Lord God, who provided us the strength, hope and courage to continue doing our work. Ms. Lina Hervas, who helped and guided us as we are writing our paper, Also to the librarians who lend us some books about Hypertension. Refuerzo and Barameda family welcomed us warmly to their house, for the food we have enjoyed there. This term paper is a product made possible though the contributions of many writers. The names of the authors are listed in the bibliography.

Prevention and Treatment of Hypertension in Adult Patients 1

I. INTRODUCTION Background of the Study

People should be more conscious of their heart nowadays. Clinical studies show that cases of Cardiovascular Disease (CVD) continue to increase. The World Health Organization predicts that by the year 2020, up to 40 percent of all deaths will be cardiovascular disease related. The leading cause of death in the World is cardiovascular disease account for almost 15 million deaths approximately, 30 percent of death worldwide in 1995. According to the World Heart Federation, the number of cardiovascular diseases is quite alarming, there are about 17 million deaths annually caused by cardiovascular disease. It is even more dramatic, when compared to other causes of death. The World Health Organization said that 30 percent of deaths are due to cardiovascular disease, as against HIV/AIDS five percent, and malaria two percent. In the United States, the diseases of the heart and circulation are the leading cause of death and disability, afflicting more than 27 million children and adults, and killing more than 1 million annually. Among the 27 million people having heart and blood vessel diseases, high blood pressure is present in about 21 million, coronary heart disease and heart attack in over 4 million, rheumatic heart disease in 1.6 million, and stroke in 1.6 million. Cardiovascular diseases claim more lives than all other causes of death combined, and heart attack alone is the largest single cause of death in the United States, accounting for one-third of all male deaths between the ages 35 and 65.

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Prevention and Treatment of Hypertension in Adult Patients 2 Cardiologists warn that the rapid change in people’s lifestyle and diet are causing the prevalence of different heart disease not only among older but also younger people. The Pharmaceutical companies continue to seek better means of discovering new and effective drugs for the treatment of cardiovascular diseases. Pfizer, a global health-care company has budget of $4.7 billion and 12,000 highly-skilled researchers working at research and development facilities in more than 20 countries around the world. The Pfizer is able to discover safe and cost-effective medicines for hypertension and highcholesterol, the tow main causes of cardiovascular disease. Its investment in the study of the human genome will allow them to know other causes of cardiovascular disease in the future, and help develop new drug treatments for the said disease. Pfizer is a union between Pfizer Inc. and Warner-Lambert. It is a global research base company that discovers, develops, and manufactures innovative medicines.

Statement of the Problem

The researchers’ study about “Prevention and Treatment of Hypertension in Adult Patients” tends to find and seek best answers and solutions to the following questions: 1. How can hypertension in adult patients be prevented? 2. Why does hypertension commonly experienced by adult patients? 3. What are the treatments in order to remedy hypertension? 4. What are the programs needed to be develop and implemented to remedy hypertension in adults?

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Prevention and Treatment of Hypertension in Adult Patients 3 Scope and Delimitation

The researcher will discuss the common illness suffered mostly by people called “Hypertension”. The research is limited only on the prevention on how to stay away from hypertension on adult patients. The researchers will discuss all preventive ways in order to avoid hypertension. These preventions will help the readers especially those who are concern understand and gain knowledge about the topic which in one way they can also apply to hypertension. Furthermore, the readers will also elaborate some effective and useful treatments in order to remedy hypertension.

Significance of the study This study would be beneficial not only to the researchers, but also to the following people: To the students, this study will give them some relevant information about hypertension. To the adult patients, they will be aware of the possible risks of having hypertension. This paper will serve as their guide in preventing hypertension. To the nursing students, that they will attain some useful information and facts about hypertension. To the non hypertensive people, this paper will serve them as a warning that hypertension is a silent killer and to change their lifestyle as early as possible. This will be an informative paper for them to know the importance of their heart while they are young. _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 4 To the government, they will implement more programs to remedy hypertension. It is also to give awareness to the country concerning hypertension. Definition of Terms These are the following terms that the researchers used in this study: Blood pressure. This refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. Cardiovascular. A system that regulates the circulation of blood in our body Chlamydia pneumonia bacteria. A type of bacteria that is the chief suspect behind many strokes and heart attacks. Complications. Any disease or disorder that occurs during the course of (or because of) another disease. Dyslipidemia. The elevation in cholesterol or thyglycerides HBP. It stands for High Blood Pressure. Hypertension. Is a repeatedly elevated blood pressure exceeding 140 over 90 mmHg with a systolic pressure above 140 with a diastolic pressure above 90. LDL cholesterol. Is more likely to clog blood vessels because it carries the cholesterol away from the liver into the bloodstream, where it can stick to the blood vessels. Lifestyle. A way or style of living that reflects the attitude and values of a person or group. Sagittal abdominal diameter. It is a measure of visceral obesity, also called Supine Abdominal Height. Sphygmomanometer. Is an instrument used to measure the blood pressure. _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 5 II. COLLECTION OF READINGS The readings presented are the collection of related literatures that were by the researchers. It is a collection of books, encyclopedia, magazines and periodicals which were published locally and internationally. The readings are related to the topic Prevention of Hypertension in Adult Patients.

Local Literature

Dr. Francisco Tranquilino, a cardiologist and training officer at the Philippine General hospital says that in managing patients, doctors also consider the long-term effects and complications of a particular medicine on the illness like hypertension. As said by Dr. Mariano Lopez, the most common ailment nowadays is hypertension which damages the heart and kidneys, both vitals organs. He also stated that if we want to live our lives longer, invest in ourselves. We should have less-sodium and fat-trimmed diet. Avoid smoking and drinking. But he added also that diet and lifestyle may not be enough to control our high blood pressure thus, we have to maintain drug which we have to take at the same time everyday. Based on research studies conducted by the Cardiology Division of the Department of Health (DOH), cardiovascular disease claims thousands of lives in the Philippines, caused by risk factors. In an article found in Manila Bulletin, 21 percent of Filipinos are hypertensive and that the prevalence in the elderly population is near half. This means that every one out of two elderly Filipinos are Hypertensive.

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Prevention and Treatment of Hypertension in Adult Patients 6 Hypertension is found more often in men than in women. Postmenopausal women are affected as well. It tends to run in families (Dr. J. J. Pujalte Jr., 2004). There are some conditions that may lead to hypertension as follows: pregnancy, use of hormones like estrogen (found in birth control pills), and tumors that secrete hormones that raise blood pressure (for example, the adrenal glands). He also enumerates the following symptoms: headaches, nape pains, chest pain or tightness, nosebleeds, blurring of vision, confusion, and memory loss. These are the warnings of severe hypertension. The following may lead to secondary hypertension such as: palpitations or the sensation of the heart jumping, too much perspiration, muscle cramps, weakness and frequent urination. A researcher named, Tyrone Reyes have long suspected a connection between heart disease and some sort of chronic inflammation affecting the arteries. One leading theory is that the chlamydia pneumonia bacteria, a common source of respiratory infections, also causes heart attacks by disrupting the plaques that build up and narrow diseased arteries. Large trials are under way to see whether giving antibiotics to heartdisease patients will show tangible results. Pfizer Inc. is testing its popular antibiotic arzithromycin (Zithromax) as a heart-disease treatment in a clinical trial nicknamed the wizard trial. Ms. Julie E. Buring stated that the multivariate relative risks across increasing quintiles of high-fat dairy product intake, in contrast, were 1.00, 1.02, 1.01, 1.00, and 0.97 (P for trend: 0.17). It was found that intakes of low-fat dairy products, calcium, and vitamin D were each inversely associated with risk of hypertension in middle-aged and

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Prevention and Treatment of Hypertension in Adult Patients 7 older women, suggesting their potential roles in the primary prevention of hypertension and cardiovascular complications. In fact, people with hypertension actually appear to be eating worse than before the government-approved guidelines were introduced, according to the report published in the Feb. 11 issue of the Archives of Internal Medicine. The study said young people, blacks and the obese fared the worst in their dietary habits. A diet high in fruits, vegetables and low-fat dairy products has been shown to help significantly lower blood pressure, according to background information in the article. This Dietary Approaches to Stop Hypertension (DASH) method, first published in 1997, complements other lifestyle changes, such as reducing sodium and losing weight, and can also help lower cholesterol levels, previous studies have shown.The DASH diet is recommended by the Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure for all patients with hypertension.The study analyzed dietary, health and personal data of adults collected in surveys done by the U.S. Centers for Disease Control and Prevention from 1988 to 1994 and from 1999 to 2004. Using the DASH guidelines, researchers identified goals for eight target nutrients and calculated scores ranging from zero to nine for individuals with and without hypertension from the surveys; those who scored a 4.5 or higher were considered to be following the diet. Foreign Literature In an article of Malaya, the World Heart Federation states that the number of cardiovascular diseases cases is quite alarming. There are about 17 million deaths _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 8 annually caused by Cardiovascular diseases particularly, hypertension. According to their recent study, without effective intervention or prevention activities, cases of heart diseases will continue to rise sharply. As stated by Dr. Ronald Santos, the prevalence rate of Hypertension in the United States. Europe and Japan is 3:5, while in Lebanon and Saudi Arabia it is 2:5. A data obtained from National Center for Health Statistics, Hypertension and other cardiovascular diseases are the leading causes of death rates in United States. The study, based on data collected on 10,874 Chicago men ages 18-39 who were studied from 1967 to ’73 and then followed for an average of 25 years, is comprehensive yet on the long term effects of high blood pressure in young men said Dr. Martha Daviglus. Referring to New York Reuters Health, the more belly sticks out the greater your risk of developing heart disease. A new study shows that the more Sagittal Abdominal Diameter, the stronger the risk to have a heart disease. The Losartan Intervention for Endpoint Reduction of Hypertension (LIFE) study, which was conducted in 9,193 patients with hypertension and left ventricular hypertrophy (enlarged heart), showed that losartan significantly reduced the combined risk of cardiovascular death, heart attack and stroke. In an article found in Manila Star, said by British researchers, it’s the brain and not the heart that is responsible for high blood pressure. In details, the scientist said that hypertension can lead to heart attacks, strokes, and kidney damage is an inflammatory vascular disease of the brain rather than the heart. Professor Julian Paton from Bristol University Western England states that finding lead to new ways of treating condition. A _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 9 statement from Boston (Reuters) says a blood test that detects damage caused by a heart attack is far more reliable than previously thought because it works in people with kidney problems, researchers reported in the New England Journal of Medicine. Another article found in Manila Bulletin, according to a Harvard Medical School Study, showed that losing the weight will lessen the risk for hypertension. An increase in weight, about 10 – 20 pounds, will put the life in danger. According to New York (Reuters Health), in African-Americans with poorly controlled high blood pressure (hypertension) and high cholesterol, treatment with a single pill containing a blood pressure-lowering drug and a cholesterol-lowering drug may prove particularly useful, researchers say. Getting blood pressure and "bad" LDL-cholesterol under control has been harder to do in African Americans than in the overall U.S. population, note the researchers in a report in Mayo Clinic Proceedings, a medical journal. The current study, they say, suggests that the single-pill option may help more of them reach their goals. The single pill combo is marketed as Caduet by Pfizer, the company that supported the study. Caduet contains the drug amlodipine, used to treat high blood pressure and atorvastatin, used to lower cholesterol. In the study, 499 African Americans with uncontrolled hypertension and "dyslipidemia" (elevations in cholesterol or triglycerides) received Caduet in eight different dosage strengths, which were flexibly increased as needed.

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Prevention and Treatment of Hypertension in Adult Patients 10 "We have shown, in a study designed to approximate 'real world' practice in African Americans with poorly controlled hypertension and dyslipidemia that single-pill amlodipine/atorvastatin provides substantial improvement in both risk factors," Dr. John M. Flack, from Wayne State University Health Center in Detroit and colleagues report. "Control of hypertension and dyslipidemia had been achieved in fewer than 1 percent of patients at study entry but was attained by almost half by week 20," they further note. More specifically, they report that 236 (48.3 percent) of 489 patients reached both their blood pressure and LDL-cholesterol goals, versus 4 (0.8 percent) of 484 at baseline. Separately, they found that 280 (56.8 percent) of 493 patients reached BP goals, versus 7 (1.4 percent) of 494 at baseline, while 361 (73.7 percent) of 490 reached LDLcholesterol goals compared with 138 (28.5 percent) of 484 at baseline. The single-pill combination was well tolerated; the most common treatmentrelated adverse events were peripheral swelling (3.4 percent), headache (2.2 percent), muscle pain (2.2 percent) and constipation (2.0 percent), none of which were considered severe.

Relevance of the study This study is relevant to adults because they have the greater chances of having hypertension. Adults are more prone of having this disease because as they get older, _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 11 their bodies get weak also. Therefore, they have less ability to fight that specific disease. In other words, their immune system weakens. This study also states that it is highly recommended to have a lifestyle change. It is recommendable to stop smoking; drinking alcohol, eating high-cholesterol foods and even stress can damage the heart by blocking the arteries, causing to pump blood harder.

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Prevention and Treatment of Hypertension in Adult Patients 12 III. SUMMARY, CONCLUSION, RECOMMEDATIONS The

following

stated

below

are

the

summary,

conclusion,

and

the

recommendation of the researchers for the readers in the topic Prevention and Treatment of Hypertension in Adult Patients.

Summary

In this study, the researchers found out that the hypertension in adult patients can be prevented by changing the bad habits like: smoking, drinking alcohol, eating too much fatty foods, too much drinking of coffee. It can also be prevented by exercising, balnce diet, and avoiding stress. Hypertension can be treated by antibiotic arzithromycin (Zithromax) an antibiotic produced by Pfizer Inc. The writers also found out that hypertension can be treated if the high blood person will lose weight, stop eating fatty foods, exercising daily and continually taking medicines prescribe by their doctors. The researchers found out that hypertension can be found more often in men than in women. Postmenopausal women are affected as well. There are some conditions that may lead to hypertension as follows: pregnancy, use of hormones like estrogen and tumors that secrete hormones that raise blood pressure. The writers discovered some symptoms of hypertension like headaches, nape pains, chest pain or tightness, nosebleeds, blurring of visions, confusion and memory loss. The following may lead to secondary hypertension such as palpitation or the

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Prevention and Treatment of Hypertension in Adult Patients 13 sensation of heart jumping, too much perspiration, muscle cramps, weakness and frequent urination. The researchers also discovered that intakes of low-fat dairy products, calcium, and vitamin D were each inversely associated with risk of hypertension in middle age and older women, suggesting their potential roles in the primary prevention of hypertension and cardiovascular complications. A diet high in fruits, vegetables and low-fat dairy products has been shown to help significantly lower blood pressure.

Conclusion Hypertension in adult patients can be prevented by kicking the bad habits in order to have a healthy heart: quit smoking, exercise, maintain, reduce dietary cholesterol, reduce coffee intake and avoid stress. The researchers have found that the DASH diet (Dietary Approaches To Stop Hypertension), which is very similar to the Pritikin Eating Plan, lowers blood pressure as well as or better than any drug. Both DASH and Pritikin promote menus that are low in fats, salt, cholesterol, red meat, and sweets; high in fruits, vegetables, whole grains, and beans; and moderate in seafood, poultry, nuts, and low-fat or nonfat dairy foods. Adult patients are more hypertensive because of unhealthy lifestyle practices and reckless diet in their younger age. Hypertension in adult patients can be prevented by kicking the bad habits in order to have a healthy heart: quit smoking, exercise, maintain, reduce dietary cholesterol, reduce coffee intake, and avoid stress.

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Prevention and Treatment of Hypertension in Adult Patients 14 Adult patients are more hypertensive because of unhealthy lifestyle practices and reckless diet in their younger age. Adults are more prone of having of having this disease because as they get older, their bodies will also get weak.

Recommendations Here are the recommendations that the researchers would like to share to all the readers. 1. The adult patients it is highly recommended that they should change their lifestyle. They should avoid smoking, drinking alcohol, exercise daily, and reduce coffee intake and stress. By having the right kind of food, hypertension and other diseases can be prevented. Eating too much of fatty foods which contains bad cholesterol that can clog the arteries in the heart, thus preventing the blood to flow normally. 2. The government should endorse about stop or drinking moderately, making programs like exercising, jogger’s lane, aerobics, Taebo, walking marathon, eating low and non-fat foods, and reducing weight. So that people will be encourage to lessen their weight and to prevent hypertension. 3. The nursing students should have knowledge about hypertension for they will be handling hypertensive patients. Nurses are the one who will take charge of the patients while the doctor is not around so they should be well informed about this disease they are supposed to know the first aids when hypertension had started infecting the patients’ health. 4. And lastly, the non hypertensive people should watch on their diet and lifestyle. They should stop abusing their health and stop their bad habits. And to keep their body fit and _______________________________________________________________________ Department of Languages

Prevention and Treatment of Hypertension in Adult Patients 15 healthy, they should find time for exercising. In the times they are at the party and can’t help but to eat too much fatty food, they must drink supplements that can help their digestion. Or most likely, they should control the intake of these fatty foods. One last thing is to reduce coffee intake.

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Prevention and Treatment of Hypertension in Adult Patients 16

Resume

Aldemita, Ma. Kristal Gale S. 98-B Main Ave. Murphy Cubao Quezon City [email protected] 09176068064 Birth date Age Nationality Civil Status Height

: July 28, 1990 : 17 : Filipino : Single : 5’4

Birth place Sex Language/s Religion Weight

: Mandaluyong City : Female : Filipino, English : Christian : 110 lbs.

FAMILY BACKGROUND

Father’s Name: Gilluermo Montelora Age : 59 Occupation : sea man Contact No. : ---No. of siblings: ---Name of Siblings: ----

Mother’s Name: Marvelyn Aldemita Age : 47 Occupation : civilian employee Contact No. : 09154012113 Age: ----

EDUCATIONAL BACKGROUND ____________________________________________________________________ Primary School Address Year Graduated Awards

: San Joaquin Central School. : Iloilo City : 2003 : most industrious, Drum corp. member

Secondary School Address Year Graduated Awards

: Stella Maris College : Cubao, Quezon City : 2007 : pep squad member

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Prevention and Treatment of Hypertension in Adult Patients - 17 -

Resume

Karla Charmaine P. Barrameda 14-F East Road Cubao Quezon City [email protected]/ [email protected] 09224011754 Birth date Age Nationality Civil Status Height

: December 8, 1990 : 17 yrs. old : Filipino : Single : 5’3”

Birth place Sex Language/s Religion Weight

: Quezon City : Female : Filipino/ English : Born Again Christian : 120 lbs.

FAMILY BACKGROUND

Father’s Name: Dioscoro B. Barrameda Age : ---Occupation : ---Contact No. : ---No. of siblings: 2 Name of Siblings: Sheryl May P. Barrameda Name of Siblings: Dennis Alvin P. Barrameda

Mother’s Name: Merlyn P. Barrameda Age : 47 yrs. old Occupation : Government Employee Contact No. : 09228333077 Age Age

: 27 yrs. old : 23 yrs. old

EDUCATIONAL BACKGROUND ____________________________________________________________________ Primary School Address Year Graduated Awards

: : : :

Aguinaldo Elementary School 18th avenue Murphy Quezon City April 2003 glee club member

Secondary School Address Year Graduated Awards

: : : :

Juan Sumulong High School 18th avenue Murphy Quezon City March 2007 glee club member, GSP officer

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Prevention and Treatment of Hypertension in Adult Patients - 18 -

Resume Mylene B. Refuerzo 208 J. Ruiz Street San Juan Metro Manila [email protected] 09176057557 Birth date Age Nationality Civil Status Height

: March 7, 1990 : 18 : Filipino : Single : 5’4

Birth place Sex Language/s Religion Weight

: San Juan : Female : Filipino, English : Catholic : 120bs.

FAMILY BACKGROUND

Father’s Name: Glenn J. Refuerzo Age : 41 Occupation : businessman Contact No. : 7443842 No. of siblings: 7 Name of Siblings: Age: Francis B. Refuerzo 22 yrs. old Michelle Ann B. Refuerzo 19 yrs. old Jayvee B. Refuerzo 14 yrs. old

Mother’s Name: Edelyn B. Refuerzo Age : 40 Occupation : Housewife Contact No. : 7443842 Glenn B. Refuerzo, Jr. Jake B. Refuerzo Myra Mae B. Refuerzo Madel B. Refuerzo

13 yrs. old 11 yrs. old 9 yrs. Old 8 yrs. Old

EDUCATIONAL BACKGROUND ____________________________________________________________________ Primary School Address Year Graduated Awards

: Salapan Elementary School : St. Veloso Street San Juan : 2002 : 3rd honorable and Best in EPP

Secondary School Address Year Graduated Awards

: Central Colleges of the Philippines : Quezon City : 2006 : Overall Top 8, Co-Curricular Award.

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Prevention and Treatment of Hypertension in Adult Patients - 19 -

Resume

Jackylin L. Tan 56 Scout Limbaga Street Timog Ave., Quezon City [email protected]/[email protected] 09162340523 Birth date Age Nationality Civil Status Height

: December 19, 1988 : 19 : Filipino : Single : 5’3

Birth place Sex Language/s Religion Weight

: Quezon City : Female : Filipino, English : Christian : 100 lbs.

FAMILY BACKGROUND

Father’s Name: Bobby C. Tan Age : 56 Occupation : businessman Contact No. : 4166138 No. of siblings: 6 Name of Siblings: Age: Elizabeth L. Tan 21 yrs. old Caroline L. Tan 16 yrs. old Mark Anthony M. Tan14 yrs. old

Mother’s Name: Priscilla L. Tan Age : ---Occupation : ---Contact No. : ---Clara Jane M. Tan. Antoinette M. Tan Bernadtte M. Tan

13 yrs. old 8 yrs. old 6 yrs. Old

EDUCATIONAL BACKGROUND ____________________________________________________________________ Primary School Address Year Graduated Awards

: Grace Christian High School : Grace Village, Sto. Domingo, Quezon City : 2003 : glee club member

Secondary School Address Year Graduated Awards

: Grace Christian High School : Grace Village, Sto. Domingo, Quezon City : 2007 : glee club member

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Prevention and Treatment of Hypertension in Adult Patients - 20 -

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