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-CCS..45 yr old high BP reading for the 1st time- - pindi

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-CCS..45 yr old high BP reading for the 1st time- - pindi
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#11
10-23-2008, 11:35 PM
This case is still unsolved.....Sad...

pt will die of hypertensive crisis if not given a proper shape to the case...Smile Smile Smile
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#12
10-23-2008, 11:36 PM
i know...we are sitting on this one....lol... Smile
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#13
10-24-2008, 04:24 PM
up..
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#14
10-25-2008, 01:45 PM
up...
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#15
10-27-2008, 11:20 AM
hey jayhind ,

i just learnt form the UW ccs case that you call such a pt back after one week...
and on this visit you do a complete physical and get following labs...

( i have forgotten what previous post said about this case on this thread, i might be repeating.)

orders:
cbc
bmp
ca, mg, phos
ua
ekg
lipidprifile
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#16
10-27-2008, 11:29 AM
stage 1 htn 140-159/90-99
stage 2 htn 160-179/100-109
stage 3 htn >180/>110

first u have to establish what the cause is...
secondly access for end organ damage....

if pt has DM, evidence of end organ damage or cvs risk factors+ treat with anti-hypertensives......

for borderline and stage 1..and pt with NO risk factors..start npnpharmacologocal treatment.. which can last upt o 12 mths....

stage 2 & 3....medications..needed.....
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#17
10-27-2008, 11:45 AM
Thanks pindi
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#18
10-27-2008, 12:02 PM
ur welcome jay...
another very imp point...

if a STAGE-1 Htn pt does not have the above mentioned 3 MAJOR risk factors...but has multiple risk factors like...smoking, obesity or fam/hx of early CAD...then you will start hime on non-pharma and pharmacological treatment for htn...like HCTZ or atenolo...

i think it's in a better shape now... Smile
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#19
10-27-2008, 12:07 PM
sound better..

I saw the case in UW...

So in Summery

Stage 1 Htn + risk factors--- start Rx on the next visit ( after 1 week)
Stage-1 Htn + no risk factor present-- we can wait for 3-6 months
Stage-2 / 3 + with/without risk factors -- start Rx on the next visit ( after 1 week)

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#20
10-27-2008, 12:12 PM
yes correct..you are!

stage I and no RFs...can wait even for 12 mths...per UW!
stage 1 and some RFs but NO DM...can wait for 6 mths... per UW.
stage 1 and multiple RFs......start some anti-htns...per UW

sp bottomline..STAGE 1 and DM...straight to anti-hypertensives!

i hope this is not confusing...
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