Hypertension

Order Description Case Study #1 Hypertension Your patient is a 69-year-old African-American female who presents for follow-up for her blood pressure. You evaluated her one month ago and at that time her blood pressure had increased (146/90 mmHg) from the previous office visit (138/88 mmHg). In the office today the patient's blood pressure is 148/92 mmHg. The patient has a history of type II diabetes mellitus, for which she takes metformin BID. Her most recent creatinine was 1.4. She admits that she has not been watching her diet as much as she should have. You decide that she needs medication to help control her high blood pressure. As you progress through these questions, please provide rationale for your answer. 1. According to the hypertension guideline management algorithm, what class or classes of medication is indicated for your patient? 2. Based upon your answer for question one, which medication would you choose, and how would you prescribe it (dosing and timing)? 3. What considerations or contraindications should be taken into account when using the medication you have chosen? 4. What non-pharmacologic blood pressure control measures would you counsel your patient on? Eating right avoiding high sodium foods, weight loss, food diary, shopping tips like how to read labels (you can add more) 5. Assume that you start your patient on your chosen medication and that she is being compliant, but her blood pressure is still not well controlled. Using the algorithm as your guide, discuss two (2) further pharmacologic steps that you might take to help your patient achieve better control of her hypertension.