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Patient case: hypertension

Patient case: hypertension

Discussion

A 52-year-old male presents to the clinic for a routine check-up. He has no complaints but reports feeling increasingly fatigued over the past few months. He has a history of being a smoker for 20 years, and his father had a history of stroke at age 60. His diet is high in salt, and he leads a sedentary lifestyle. He has not had his blood pressure checked regularly and has never been diagnosed with hypertension.

On examination, his blood pressure is measured at 160/95 mmHg on two separate readings. His heart rate is 85 beats per minute, and he appears overweight with a body mass index (BMI) of 32. Physical examination is otherwise unremarkable, with no signs of end-organ damage. Laboratory tests show normal kidney function, but his cholesterol levels are elevated. An electrocardiogram (ECG) is normal, with no signs of left ventricular hypertrophy.

The patient is diagnosed with primary (essential) hypertension. He is advised to make lifestyle modifications, including reducing salt intake, increasing physical activity, and quitting smoking. He is started on a thiazide diuretic and is referred to follow up regularly for blood pressure monitoring and further cardiovascular risk assessment.

Questions
1. What is the most likely diagnosis for this patient based on his symptoms and blood pressure readings?

A) Secondary hypertension

B) Primary (essential) hypertension

C) Hypotension

D) Heart failure

2. Which of the following is the most likely contributing factor to this patient's hypertension?

A) Family history of stroke

B) High salt intake, sedentary lifestyle, and smoking

C) Chronic kidney disease

D) Hyperthyroidism

3. What is the first-line medication prescribed for this patient to manage his hypertension?

A) Angiotensin-converting enzyme (ACE) inhibitor

B) Calcium channel blocker

C) Thiazide diuretic

D) Beta-blocker

 

4. Which of the following lifestyle changes is most important for managing this patient's hypertension?

A) Increasing caffeine intake

B) Reducing salt intake and increasing physical activity

C) Reducing water intake

D) Increasing alcohol consumption

 

Reveal answers

Answers

  1. B) Primary (essential) hypertension
  2. B) High salt intake, sedentary lifestyle, and smoking
  3. C) Thiazide diuretic
  4. B) Reducing salt intake and increasing physical activity