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Monday, October 27
Rhetorical Goals for Introduction Sections of Position Papers
IPHY 3700 Writing Process Map
Draft 1: Treatments for Hypertension
High blood pressure is a condition where the blood pumped by the heart exerts high forces on the walls of arteries, which are
the vessels by which blood flows from the heart to the body's organs, tissues, and cells. According to the American Heart
Association, approximately 73 million adults in the United States have high blood pressure, which is also called hypertension
(http://www.americanheart.org/). In 2004, more than 50,000 Americans died directly as a result of this disease. Hypertension
is a major risk factor for heart attacks and strokes, which cause more than 500,000 deaths in the U.S. every year. Blood
pressure is measured with a device called a sphygmomanometer, which consists of an inflatable arm cuff and a numbered
dial that indicates pressure values in millimeters of mercury (mmHg). Blood pressure readings are expressed with two
values. First, systolic pressure indicates how much force the blood exerts while the heart is contracting. Secondly, diastolic
pressure indicates how much force is exerted while the heart is relaxing in between contractions. Normal values of blood
pressure are slightly lower than 120 mmHg (systolic) and 80 mmHg (diastolic). High blood pressure is designated by
measures exceeding 140 mmHg (systolic) and 90 mmHg (diastolic).
One treatment for hypertension is a class of drugs called beta blockers. These drugs lower blood pressure by slowing heart
rate and reducing the heart's force when beating. The force that the heart produces when it contracts is increased by a
naturally occurring hormone called epinephrine, which is also called adrenaline. To affect the heart, this hormone must
attach to receptor molecules, called beta receptors, which are located on cardiac cells. Beta blockers are drugs that block the
beta receptors so that adrenaline cannot attach to them. Because the drugs block adrenaline, it does not have its normal effect
of increasing heart rate and contractile force. Therefore blood pressure is reduced.
High blood pressure can also be treated with another class of drugs, called angiotensin-converting enzyme inhibitors, or ACE
inhibitors. These drugs work by relaxing and dilating the peripheral arteries throughout the body. ACE inhibitors block the
formation of the hormone angiotensin-II, which naturally constricts the arteries. The drugs reduce blood pressure by relaxing
and dilating the arteries.
Doctors prescribe combinations of different medications to lower blood pressure in patients with hypertension. The purpose
of this critical review paper is to present research that has been conducted on which combinations are most effective in
lowering blood pressure without negative side effects.
Draft 2: Treatments for Hypertension
According to the American Heart Association, high blood pressure, which is also called hypertension, affects approximately
73 million adults in the United States (http://www.americanheart.org/). In 2004, more than 50,000 Americans died directly as
a result of this disease. Hypertension is a major risk factor for heart attacks and strokes, which cause more than 500,000
deaths in the U.S. every year. The prognosis for patients with hypertension is good if they seek treatment. Johnson et al. (2)
reported that in hypertensive patients who lowered their blood pressure with medication, risks of heart attack and stroke
declined by 20 to 40%. However, pharmacological approaches to treating hypertension are not always effective, and many
questions remain about the optimal drugs to prescribe for lowering blood pressure.
A major reason that medications for hypertension are not always effective is that the causes of the disease are so complex.
Over 50 medications are currently available for treating the disease. Each drug works on specific causes. For instance, drugs
in a class called beta blockers reduce blood pressure by slowing the heart rate and reducing the heart's contractile force.
Other groups of drugs influence the function of different organs and tissues. For instance, ACE inhibitors work by dilating
peripheral blood vessels and reducing the resistance to blood flow. Diuretics lower the volume of blood in the body,
reducing how much pressure the blood creates against the arteries when the heart contracts. One problem that doctors face
is determining which anti-hypertension drug to prescribe. For instance, a beta blocker that lowers blood pressure in one
patient may not work effectively in another patient, who might respond better to an ACE inhibitor.
When doctors first diagnose hypertension they usually prescribe a single drug. This approach, which is called
"monotherapy," is effective in lowering blood pressure to healthy levels in only 50 to 60% of cases (3). For individuals who
do not respond optimally to monotherapy, doctors prescribe a combination of two to four drugs. This approach is called
"combined drug therapy." While the combined approach has been reported to be effective, there are several unanswered
questions about its use. A major question deals with which drugs to combine for the optimal effects of lowering blood
pressure. Should a beta blocker be combined with an ACE inhibitor or a diuretic? Which drugs work optimally when
combined with calcium-channel blockers? Also at issue is the optimal dose for each combined drug. Should the doses be
kept at the same levels that are used for monotherapy? Or should the doses of each drug be lowered, and if so by how
much? Finally, there are concerns about dangerous side effects of combining certain drugs.
Research has been conducted to provide answers to these questions about optimal approaches to combined drug therapy for
hypertension. In this paper I will critically review studies that have addressed optimal combinations, correct dosing, and
negative side effects. Based on this review of the literature I will recommend certain drug combinations and doses for the
best outcomes in hypertensive patients.
Conventional Rhetorical Goals for Introduction Sections of Position Papers
1. Identify the issue that motivates your position paper, helping
readers understand why the issue is currently unresolved.
2. Convince readers that your issue is important and worth resolving.
3. Explain your conceptual approach to resolving your issue,
convincing readers that the approach is novel and unique.
4. State your claim and present a comprehensive and detailed
overview of how you'll support it in the body of your position paper.
Rhetorical Goal 1: Identify the issue that motivates your position paper, helping
readers understand why the issue is currently unresolved
1. Directly present the research issue—that is, the real-world problem(s) and/or
research question(s) that motivated your position paper (top of the mountain!).
2. If your issue was motivated by problems in society, explain them and present
evidence for their existence and their negative implications.
3. If your issue has not been definitively resolved due to conflicting results in previous
studies, summarize the key methods and outcomes of the contrasting research.
4. If your issue was motivated by contrasting concepts and/or theories, present the
conceptual and/or theoretical debates.
5. If your issue was motivated by a knowledge gap in the scientific field, present what
is known and what is unknown.
6. Explain why your issue has not been resolved sufficiently through previous research.
7. Present the qualifiers for your issue to define its scope.
8. Present the essential background information to help readers understand your issue.
Model Position Paper
Rhetorical Goal 2: Convince readers that your issue is important and worth resolving
1. Focus readers on the importance of the core issue.
2. Relate the importance of the issue to your specific audience, considering their
interests and scientific knowledge.
3. If you're dealing with a real-world issue, discuss its importance to society.
Who is affected? How are they affected?
4. If you're dealing with a basic research issue, discuss its importance to the
scientific field: How do problems that define your issue currently limit the
advancement of science?
5. If your argument issue involves diseases or disorders that affect large
populations, present statistics that demonstrate incidences and costs; then
speculate on how potential outcomes of your study will improve the negative
conditions.
6. Discuss the implications of failing to resolve your argument issue.
Model Position Paper
Rhetorical Goal 3: Explain your conceptual approach to resolving your issue,
convincing readers that the approach is novel and unique.
1. Describe previous experimental and conceptual approaches to
resolving your issue, pointing out their shortcomings and
explaining how they have limited scientists from resolving the
issue.
2. Present an overview of your novel and unique approach to
resolving the issue.
* Hint: Don’t use this goal to try to convince readers to accept
your claim; instead, use it to convince readers that you have a
sound conceptual approach to resolving your issue, which you’ll
follow through on in the body of the paper.
Model Position Paper
Rhetorical Goal 4: State your claim and present a comprehensive and detailed
overview of how you'll support it in the body of your position paper.
1. State your claim directly
2. Present qualifiers, or delimiters, for your claim: to whom your
claim applies, under what conditions your claim applies, and under
what conditions your claim does not apply.
3. Provide a fairly comprehensive and detailed overview of your
lines of support, the limitations you'll address and how you'll
respond to them, and the counterarguments you'll address and
how you'll refute them.
Model Position Paper