Question

1. Case scenario: Mr. Enrique Garcia is a 56 y.o. Mexican American patient with a history of hypertension for the past 10 years. He presents to the office as a new patient to get a refill of his “BP medicine.” He has been experiencing headaches and fatigue for the past 3 to 4 months and thought “it was time to start taking” his BP medicine again. He has a history of discontinuing his medications and tells you he can “tell when his BP is high.” He doesn’t remember what he was on but remembers that it made him “cough a little.”A history reveals no past medical history of MI, renal or liver disease, or diabetes. He is 5 ft, 9 in. tall and weighs 215 lbs. He works for UPS and feels he is “in good shape” because he lifts boxes all day long. His laboratory test results reveals normal CBC, normal renal/hepatic function. His vital signs are BP 166/92; HR: 78; T: 98.2; R: 18. You diagnose hypertension and will restart him on medications.             a. What medication(s) would you choose? Support your rationale.              b. What education and monitoring will he require?

Answer 1

Answer: The normal range of blood pressure is 120/80 mm Hg whereas elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below 80 mm Hg. The patient is Mexican American and has history of hypertension so it would be better to give him medications including amlodipine (Norvasc), diltiazem that will help in relaxing the muscles of blood vessels. He should be educated regarding having healthy food intake as well as taking medicine properly, drinking sufficient amount of water to stay hydrated.