Topic: Hypertension

A 56-year-old patient with newly diagnosed stage 1 hypertension has been referred to you for counseling regarding lifestyle modifications. He is married, with four children — two in high school, two in college. His job as a senior vice-president for a major retail chain requires that he work long hours and frequently eat at restaurants. He smokes two packs of cigarettes a day, has a body mass index (BMI) of 29 kg/m2, and a waist-hip ratio of 1.6. He usually drinks one to two dry martinis to relax after he gets home from work.

How would you develop a realistic plan to help this patient reduce his blood pressure and prevent complications?
Which risk factors would be among your top two or three priorities for this patient, and what interventions or recommendations would you provide for modifying these?


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Hypertension is a common chronic condition currently on the rise, and poor management can result in complications, which could potentially be fatal (Mills et al., 2020). Therefore, I would start by explaining to the patient the risks associated with hypertension, primarily when not adequately managed, hence the need for developing the intervention plan. Therefore, developing a realistic plan would include involving the patient in the entire process. This includes advising him on the need to be compliant with the antihypertensive medications prescribed to him (Ferdinand & Nasser, 2017). Besides, it would also be essential to inform the patient that his current health condition could be exacerbated by his behaviors and practices, such as smoking, drinking, being overweight, and increased consumption of fast foods at restaurants. Therefore, it is essential to emphasize the role of lifestyle modifications since the medications would be ineffective inappropriately controlling the blood pressure when these factors still prevail, thus making the blood pressure uncontrollable and even the patient at higher risk of developing complications (Ferdinand & Nasser, 2017).
Certain lifestyle behaviors increase the risk of developing hypertension or developing complications among hypertensive individuals. Some of the patient’s behaviors could have predisposed him to an increased risk of developing hypertension (Alsinani et al., 2018). These behaviors, when continued, would increase the risk of developing complications such as renal diseases, heart diseases, or even stroke. The topmost priorities that should be addressed include the patient’s body weight, smoking and alcohol intake, and diet. From the BMI and waist-hip ratio, the patient is overweight and is almost obese. This could increase his risk of developing complications. Therefore, proper weight control through regular exercise is essential in preventing complications associated with hypertension. Besides, the patient also smokes and drinks, increasing the risk for stroke and kidney diseases (Alsinani et al., 2018). Therefore, cessation of smoking and drinking would help in reducing associated risks. Lastly, eating from fast food restaurants is also associated with a high risk of atherosclerosis and obesity. Therefore, educating the patient on an appropriate diet would help reduce the risks given that they are newly diagnosed with stage 1 hypertension.

Alsinani, T. S., Abdullah, A. A., Alghamdi, T. A., Alsaigh, S. A. S., Alanazi, M. D., Alkahtani, M. A., … & Alabdrabalrasol, E. A. (2018). Lifestyle modifications for hypertension management. The Egyptian Journal of hospital medicine, 70(12), 2152-2156. https://ejhm.journals.ekb.eg/article_9043.html
Ferdinand, K. C., & Nasser, S. A. (2017). Management of essential hypertension. Cardiology clinics, 35(2), 231-246. https://www.cardiology.theclinics.com/article/S0733-8651(16)30137-0/abstract
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237. https://www.nature.com/articles/s41581-019-0244-2


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