A 56-year-old man comes into your office as a new patient. Seven years ago, at a workrelated health screening, he was diagnosed with hypertension with a blood pressure of 140/90. He saw a physician who prescribed a “medication” and encouraged him to lose some weight, diet, and exercise

. Since that time, the patient has not sought medical attention.  What is the probable diagnosis?  What are other possible diagnoses?  At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why? Probable diagnosis The probable diagnoses for this patient would e hypertension. According to 2017 guideline, the normal blood pressure would range in between 120/80 mmHg. However, if the values exceed this then the bp will be elevated and it will be categorized as hypertension. There are two stages of hypertension. These are stage 1 and stage 2. The stage would include 130 to 139 mmHg and lower value of 80-89 mmHg. The stage two will include >140 mmHg and >90 mmHg. So, this patient would be considered as on stage two of hypertension. Other possible diagnoses Hyperthyroidism, myocardial infarction, hypertrophic cardiomyopathy.

The probable test for this patient would be ambulatory monitoring which would include 24-hour blood pressure monitoring which will confirm if the patient has high blood pressure or not. Other test would include lab test, ECG and echocardiogram. In the laboratory test, the physician should recommend urine test (urinalysis) and blood tests which include cholesterol test as well. The ECG which is a rapid and painless test would be recommended for the electrical activity of heart (Carey et al., 2017). On the other hand, the doctor must also recommend echocardiogram to look for other evidence for heart disease based on the signs and symptoms of test findings. This will create a picture of the heart using sound waves. Medications Among the medications for treating hypertension are:  Diuretics Diuretics, often known as water pills, are drugs that aid in the elimination of salt and water from the body through the kidneys. Those medicines are frequently the first to be tested to treat high blood pressure (Rysz et al., 2020) Diuretics are classified into three types: thiazide, loop, and potassium sparing. Which one your doctor prescribes is determined by your blood pressure readings as well as any other medical issues you may have, like renal disease or heart failure. Chlorthalidone, hydrochlorothiazide (Microzide), and other diuretics are routinely used to treat high blood pressure

These drugs, which include lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril, and others, assist relax blood arteries by inhibiting the development of a natural substance that narrows them.  Angiotensin II receptor blockers These drugs relax blood arteries by inhibiting the activity, rather than the creation, of a naturally occurring substance that constricts blood vessels. Candesartan (Atacand), losartan (Cozaar), and other ARBs are examples.  Calcium channel blockers These drugs, which include amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, and others), and others, relax the muscles in your blood arteries. Some will cause your heart rate to slow (Wajngarten and Silva, 2019). Calcium channel blockers may be more effective than ACE inhibitors alone in elderly persons and those of African descent. References Carey, R. M., Whelton, P. K., & 2017 ACC/AHA Hypertension Guideline Writing Committee*. (2018). Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Annals of internal medicine, 168(5), 351-358. Rysz, J., Franczyk, B., Rysz-Górzyńska, M., & Gluba-Brzózka, A. (2020). Pharmacogenomics of hypertension treatment. International Journal of Molecular Sciences, 21(13), 4709