CASE STUDY SCENARIO Mr. BA is a 65 –year-old, African Canadian male from Brampto

Question

CASE STUDY SCENARIO

Mr. BA is a 65 –year-old, African Canadian male from Brampton, Ontario, Canada. He came to the Emergency Department with his wife of 30 years. Mr. BA was sent to the Emergency Department by his primary healthcare provider because “he has not been feeling well” for the past few days. He describes fullness in his head and chest without any associated symptoms. His medical history is pertinent only for primary hypertension, and he states that he ran out of his medication 2 weeks before he started experiencing symptoms.

Physical examination reveals an anxious man with a BP of 230/130 mm Hg with a heart rate of 108 bpm. Respirations are mildly elevated at 22 breaths per minute. No papilledema is seen on funduscopic examination. Lungs have bilateral rales one quarter up from the bases. Cardiac examination reveals a regular tachycardic rhythm with normal S1 and S2. Jugular venous pressure is normal but demonstrate sustained fullness with abdominal pressure. Apical pulse is prominent. No pedal edema, or abdominal bruits detectable. Peripheral pulses are equal.

Laboratory test results reveal normal CBCs, electrolytes, and renal functions. Several erythrocytes are seen in the urine. Oxygen saturation is 89% on room air. A 12-lead EKG shows sinus tachycardia, left axis deviation, 4-6mm ST-segment depression across the pericardium. A chest X-ray is significant for moderate pulmonary venous congestion and cardiomegaly.

The findings indicate that patient is in hypertensive crisis and in need of immediate medical attention and he is very anxious. BA is 5 feet 8 inches tall and weighs 200 pounds. He reports no form of regular exercise or special diet. BA’s diet entails carbohydrate dense foods, salted cod fish, bacon, goat meat, and high glycemic index beverages. BA smoke half pack of cigarette for the past five years and drinks a case of beer on weekends. BA father died of a heart attack at age 60. Brother had a stroke at age 50.

PART 1: Questions

Identify and describe three (3) potential long-term complications of hypertension? Explain your Answer with atleast 2 to 3 citations and reference within 5 years

Explanation / Answer

Essential hypertension (also called primary hypertension or idiopathic hypertension) is the form of hypertension that by definition has no identifiable cause. It is the most common type of hypertension, affecting 95% of hypertensive patients, it tends to be familial and is likely to be the consequence of an interaction between environmental and genetic factors. Prevalence of essential hypertension increases with age, and individuals with relatively high blood pressure at younger ages are at increased risk for the subsequent development of hypertension. Hypertension can increase the risk of cerebral, cardiac, and renal events.Essential hypertension remains a major modifiable risk factor for cardiovascular disease (CVD) despite important advances in our understanding of its pathophysiology and the availability of effective treatment strategies. High blood pressure (BP) increases the risk of CVD for millions of people worldwide, and there is evidence that the problem is only getting worse. In the past decade, age-adjusted rates of stroke incidence have risen, and the slope of the age-adjusted rate of decline in coronary disease has leveled off.

The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to:

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