JNC8 and AHA/ACC Assignment

JNC8 and AHA/ACC Assignment

Mrs. Lyons, a 57-year-old African American woman, recently experienced headaches and received an elevated blood pressure reading of 168/99 at her workplace health fair. Concerned about her health, she visited the drug store on three separate occasions to monitor her blood pressure, resulting in readings of 145/90, 150/89, and 140/88. Additionally, during the health fair, she was informed that her BMI was elevated. Her cholesterol levels were also assessed, revealing a total cholesterol level of 250, LDL at 138, HDL at 48, and Triglycerides at 170.

Family-Centered Health Promotion Strategies Essay

It’s worth noting that Mrs. Lyons had not consulted a primary care provider in over five years. During her last visit five years ago, her blood pressure was measured at 135/95, with elevated LDL and triglyceride levels. At that time, she was advised to monitor her blood pressure at home and make dietary and lifestyle adjustments. She was scheduled for a follow-up appointment to review her blood pressure logs and reassess her lab results, which unfortunately she did not fulfill.

During her current clinic visit, her vital signs were recorded as follows: BP 146/92, HR 90, Temp 98.4, RR 12, O2 98%, Height 5’5, Weight 220 lbs, BMI 36.6. She is not currently taking any medications and has no known drug allergies. Her family history includes her brother and sister, both of whom have been diagnosed with hypertension and diabetes mellitus. Mrs. Lyons’ primary diagnoses are HTN, Obesity, and Hyperlipidemia.

Now, let’s address the questions posed:

Q1. Please briefly discuss the first-line treatment recommendations from JNC8, and the AHA/ACC for a patient with no other major comorbidities.

According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC8) guidelines and the American Heart Association/American College of Cardiology (AHA/ACC) guidelines, initial treatment for hypertension in patients without major comorbidities typically involves lifestyle modifications. These include adopting a heart-healthy diet (such as the DASH diet), engaging in regular physical activity, limiting sodium intake, moderating alcohol consumption, and achieving and maintaining a healthy weight. Medication may be considered if lifestyle changes alone are insufficient to achieve blood pressure control.

Q2. What are the recommended medications to start this specific patient on?

Please provide the drug class, generic & trade name, and initial starting dose.

Considering Mrs. Lyons’ diagnosis of hypertension, obesity, and hyperlipidemia, the following medications may be considered:

a. Antihypertensive Medication (Class: ACE Inhibitor)
– Generic Name: Lisinopril
– Trade Name: Prinivil, Zestril
– Initial Dose: 10 mg once daily

b. Lipid-Lowering Medication (Class: Statin)
– Generic Name: Atorvastatin
– Trade Name: Lipitor
– Initial Dose: 20 mg once daily

Q3. Please discuss the mechanism of action of each of the drugs you listed.

a. Lisinopril (ACE Inhibitor): Lisinopril works by inhibiting the angiotensin-converting enzyme (ACE), which converts angiotensin I into angiotensin II. Angiotensin II is a potent vasoconstrictor, and by inhibiting its formation, lisinopril relaxes blood vessels, reducing blood pressure.

b. Atorvastatin (Statin): Atorvastatin belongs to the statin class of drugs, which inhibit HMG-CoA reductase, an enzyme involved in cholesterol synthesis. By reducing cholesterol production, atorvastatin lowers LDL cholesterol levels in the blood.

Q4. Please discuss the side effect profile of each medication you listed.

a. Lisinopril (ACE Inhibitor): Common side effects may include cough, dizziness, fatigue, and elevated blood potassium levels. Rare but serious side effects include kidney dysfunction and angioedema (swelling of deeper skin layers).

b. Atorvastatin (Statin): Common side effects may include muscle pain, elevated liver enzymes, and gastrointestinal symptoms. Rare but serious side effects include muscle breakdown (rhabdomyolysis) and liver dysfunction.

Q5. Are there any interactions between any of the medications you prescribed?

There are no significant drug interactions between lisinopril and atorvastatin. However, it is essential to consider potential drug interactions with any other medications Mrs. Lyons may be taking in the future.

Q6. What other non-pharmacological interventions would be suggested?

In addition to medication, non-pharmacological interventions for Mrs. Lyons may include:

– Dietary modifications: Encouraging a heart-healthy diet, such as the DASH diet, which emphasizes fruits, vegetables, whole grains, lean proteins, and limited sodium and saturated fat.
– Regular physical activity: Recommending at least 150 minutes of moderate-intensity aerobic exercise per week.
– Weight management: Setting realistic weight loss goals and providing support for achieving and maintaining a healthy weight.
– Smoking cessation: If applicable, assisting with smoking cessation efforts to reduce cardiovascular risk.

In conclusion, Mrs. Lyons’ management plan includes antihypertensive and lipid-lowering medications, along with lifestyle modifications, to address her hypertension, obesity, and hyperlipidemia while minimizing potential side effects and drug interactions. Regular follow-up and monitoring of her progress are essential components of her care plan.