Author Question: Because M.P.'s BP continues to be high, the internist decides to put her on another drug and ... (Read 34 times)

jerry coleman · **on:** Jun 25, 2018

Because M.P.'s BP continues to be high, the internist decides to put her on another drug and recommends that she try again with the HCTZ.

According to the JNC 8 national guidelines, what drug category or categories are recommended for M.P. at this time?

Question 2

During today's visit, M.P.'s vital signs are as follows: BP: 162/102; P: 78; R: 16; T: 98.2 F (36.8 C). Her most recent basic metabolic panel (BMP) and fasting lipids are within normal limits.

Her height is 5 ft, 4 in, and she weighs 110 lb. She tells you that she tries to go on walks but does not like to walk alone and so has done so only occasionally.

What risk factors does M.P. have that increase her risk for cardiovascular disease?

frogdreck123456 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

For patients of African descent who do not have diabetes mellitus or chronic kidney disease, the
guidelines recommend calcium channel blockers (CCBs) and thiazide-type diuretics to be started
before other antihypertensive drugs. If the CCBs and thiazide-type diuretics are not effective, the
guidelines recommend a dosage adjustment and/or the addition of either an angiotensin-converting
enzyme (ACE) inhibitor or an angiotensin receptor blocker. (Patients should not receive both an
ACE inhibitor and an ARB.) Other medication classes, such as beta blockers and alpha-blockers, are
considered after initial treatment with CCBs, thiazides, and ACE inhibitor/ARB is found to be ineffective.

Answer to Question 2

Hypertension, physical inactivity, age over 65 years, postmenopausal status, family history of
premature cardiovascular disease (mother died at age 65 years of CVA)