J.S. is a 54-year-old Hispanic woman who presents to her primary-care clinician for follow-up regarding elevated blood pressure. She was last seen 2 weeks prior with a blood pressure of 162/94 mmHg.,J.S. is a 54-year-old Hispanic woman who presents to her primary-care,Case Study:, J.S. is a 54-year-old Hispanic woman who presents to her primary-care, clinician for follow-up, regarding elevated blood pressure. She was last seen 2 weeks prior with a blood pressure of 162/94 mmHg. She has no significant medical history. Additionally, she is a 1 ppd tobacco user with a history of 25 pack-years, and she has a family history of premature cardiac death.,Evaluation:, Her vital signs are as follows: height, 5 ft. 4 in.; weight, 188 lb.; pulse, 84 beats/min; blood pressure, 168/98 mmHg; and body mass index, 32.3. As J.S. has been found to be hypertensive (>149/90) on two consecutive office visits, starting an antihypertensive medication is indicated.,Questions,:, Firstly, What is your initial choice for an antihypertensive medication in this patient? (Further, support your treatment plan with a discussion of the evidence based guideline you utilized),Secondly, Which therapeutic lifestyle change is a priority in helping J.S. achieve blood pressure control?,Thirdly, Which of the following diagnostic tests would you order for J.S. to establish a baseline before starting an anti-hypertensive?,More details;,There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers.,Further, What is the best antihypertensive medication?,According to many studies, thiazide diuretics (hydrochlorothiazide, chlorthalidone) and calcium channel blockers (amlodipine) are the place to start. Another option. ACE inhibitors (lisinopril, benazepril, etc) or ARBs (valsartan, irbesartan, losartan) are also recommend ed as a good place to start.,Lastly, What are the new antihypertensive drugs?,We review three new classes of antihypertensive drugs: imidazolines, monatepil, and neutral endopeptidase inhibitors. Imidazolines are a new generation of central acting drugs.,Attachments,Click Here To Download,
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