Hypertension Flashcards
Counsel a case of hypertension
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TELL - DEARCDT
Define: Hypertension is a condition characterized by persistently elevated systolic blood pressure i.e. the number on top to above 140mmg or more, or a diastolic blood pressure i.e. the number under to 90mmHg or more.
These two numbers are what you see when you check your blood pressure.
AETIOLOGY AND RISK FACTORS
The exact cause of hypertension is usually unknown in most patients. It is thought to be a complex interaction between genetic and environmental causes. In a few patients however, it may be as a. result of a kidney or heart problem, or due to excessive secretion of some hormones.
Risk factors for hypertension include advanced age, family history, male gender and black race which cannot be modified. While other factors like obesity, lack of exercise, increased calorie and alcohol intake, smoking and high salt intake, diabetes can also contribute to developing hypertension and these can be modified.
CLINICAL FEATURES AND COMPLICATIONS
Hypertension is described as a silent killer because high blood pressure usually has no symptoms, but it has many negative effects on the body. When symptoms occur, the patient may experience headaches, ringing of the ears or difficulty sleeping. If left untreated for months to years. complications like blurry vision/blindness, stroke, heart attack, heart failure, convulsions or erectile dystunction may develop.
DIAGNOSIS
For proper management, you will need to do a few investigations which will include blood tests like kidney function test, lipid profile to check your cholesterol and fasting blood sugar. We will also check your heart with tests like an electrocardiography, echocardiogram.
HELP/TREATMENT
To prevent complications, there should be proper control of blood pressure by lifestyle management and use of drugs if need be. You will also need to get a sphygmomanometer to check your blood pressure regularly and record the findings.
Lifestyle modification involves stress avoidance and relief like engagement in enjoyable recreational activities. We will commence the DASH diet i.e. Dietary Approach to Stop Hypertension which involves use of natural foods that are high in vitamins and minerals like potassium and low in starch and fat, especially, fruits, vegetables and low fat diary products. Reduce salt intake to less than 1 tablespoon a day.
You need to loose some weight if overweight or obese.
Reducing or stopping alcohol will also be of significant benefit, and completely avoiding cigarettes if you smoke is a priority for us to ensure normalization of your blood pressure.
You may be placed on one or more drugs, like amlodipine or lisinopril which should be taken regularly without skipping doses to ensure maximum control.
EMPATHY + PROGNOSIS
Hypertension is a manageable although not curable condition. With proper management, through the above methods, complications of the condition can be avoided, and you will live a relatively normal life.
RETELL
Do you understand all I have said?
Do you have any questions?
Kindly summarize in your own words what you have understood.
I will like to book you for an appointment in two weeks with the cardiologist.
Thank you sir, thank you ma
