Hypertension Causes and Treatment
Instructions:
Leon is an African American, 55-year-old male. He is a non-smoker, is a nondrinker, and has a healthy weight for his height. On weekends, he coaches a youth baseball team in his community and loves to eat hot dogs and nachos with the children after they play. Leon attends a community health clinic to have a routine urinalysis and blood pressure monitored. Leon attends a community health clinic to have a routine urinalysis and blood pressure monitored. At his last visit, his blood pressure was 168/92 mm Hg. Although Leon was pleased that “the lower number dropped from 96 to 92,” his physician was still concerned. He warned Leon about the dietary choices he was making and reminded him to limit his salt intake. He also renewed Leon’s prescription for diuretics and added an ACE inhibitor to Leon’s treatment regime.
Please answer these questions:
1. Speculate how Leon’s ethnicity contributes to his hypertension. What other determinants of health contribute to the prevalence of hypertensive disease in this population?
2. What is the significance of an elevated systolic pressure, even in the absence of diastolic hypertension?
3. What is the mechanism of action of the two classes of drugs Leon was prescribed for the management of his hypertension?
Solution.
Hypertension Causes and Treatment
#1
Mr. Leon ethnic group is comprised of the youth baseball team that have a culture that loves eating hot dogs and nachos. Hot dogs contain large amounts of salts. Too much salt that contains Sodium Chloride holds additional water meant to wash the salt from the body. This leads to increased pressure in some people because the held water puts stress on their heart and blood vessels. Furthermore, the hot dogs contain nitrate preservatives that could be carcinogenic with rise in temperature such as in the case of formation of nitrosamines (Grossman & Porth, 2010). On the other hand, nachos contain high fat and calories in which high fats could lead to increased weight that increases extra strain on the heart. High calories increase the amount of fat content in the body.
#2
Isolated systolic hypertension may result in an a very much reduced diastolic pressure which may increase the risk of a heart attack or stroke hence the need for considering the level of diastolic hypertension during the treatment process (Kaplan, 2015). However, elevated systolic pressure treatment in the absence of diastolic hypertension is an emerging issue which is beneficial to the elderly. The elevated systolic pressure and if possible with a lowered diastolic pressure, are a major determinant of the cardiovascular risk in the old people.
This is not strange because, the widening pulse pressure indicates the atherosclerotic stiffening of the aorta and other large vessels. This creates a small and rigid reservoir in which the systolic influx increases pressure and the diastolic emptying results in a lowered pressure greatly than in the elastic vessels (Kaplan, 2015). Furthermore, the created stiff vessels results in a faster pulse-wave velocity, through which the usual reflection of pressure wave back from the periphery happens in a midsystole instead of diastole supplementing the already increased systolic pressure and eliminating pressure and the major support of the diastolic pressure.
#3
Since Leon has a high blood pressure, the diuretics could aid him do away with the extra water and salt through the urine. The mechanism reduces the blood pressure. On the other hand, the ACE Inhibitor leads to a reduction of the production of angiotensin II that leads to an enlarged blood vessels or dilation hence reducing blood pressure (Grossman & Porth, 2010).
References
Grossman, S. & Porth, C. (2010). Porth’s pathophysiology.
Kaplan, N. (2015). New Issues in the Treatment of Isolated Systolic Hypertension.