Analyzing Hypertensive Patient Case Study Case Study

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Hypertensive Patient Case Study

Specific physical examinations in any hypertensive patient

Accuracy in the measurement of blood pressure is the basic aspect of diagnosis. Therefore, we take it over several weeks. On each visit, normally at least three blood pressure readings are taken with the difference of 2 minutes using mercury manometer.

Palpation of all peripheral pulses should necessarily be carried out. Absent, weak, or delayed femoral pulses are the sign of coarctation of the aorta or serious peripheral vascular disease. To identify any symptom of initial or extreme stage of chronic or severe hypertensive retinopathy along with arteriovenous nicking or difference in vessel wall, we conduct funduscopic examination of the eyes (Madhur & Maron, 2014).

Why order Laboratory work up

Initial laboratory tests include urinalysis; fasting blood glucose or A1c; this is due to an increase in cardiovascular risk linked with a decreased GFR level and with albuminuria. If the patient's history reveals renal artery stenosis and if a corrective mechanism is adopted, then noninvasive radiologic examinations (e.g. computed tomographic angiography [CTA], magnetic resonance angiography [MRA]) or invasive renal angiography can be carried out. The limited echocardiography investigation, rather than the complete checkup, may identify left atrial dilatation, left ventricular hypertrophy (LVH), and diastolic or systolic left ventricular dysfunction more repeatedly than electrocardiography.

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The clear sign for limited echocardiography is assessment for end-organ damage in a patient with borderline-high BP.

Types of hypertension

Malignant Hypertension

Malignant hypertension is the type of serious high blood pressure that increases quickly and can damage some organ. 140/90 is considered "Normal" blood pressure. In the patient of malignant hypertension usually blood pressure increases above 180/120 (WebMD, 2016).

Secondary Hypertension

The Secondary hypertension is the type in which high blood pressure is caused by another disease.

Renal Hypertension

The blood pressure that is increased due to kidney disease is called Renal hypertension or renovascular hypertension.

John's stage of hypertension based on JNC 8 guidelines.

Stage 2 hypertension - BP in surgery/clinic is ?160/100 mm Hg and ABPM or HBPM is ?150/95 mm Hg.

Treatment goals for Frank

In the case of John, to decrease blood pressure to less than 140/90, treatment with medication is given. Healthy life style is an important aspect in John's high blood pressure treatment. A healthy life style in his treatment can be achieved by;

Losing weight

Quitting smoking

Eating a healthy diet, including the DASH diet (eating more fruits,….....

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