2014 Evidence Based Guideline for the Management of High Blood Pressure in Adults (JNC 8 Panel Members)- are available online at http://www.hipertansiyonmd.com/wp-content/uploads/JNC-8.pdf (Links to an external site.). (you may need to copy and paste the web address into your browser search window).
A preview of the new 2014 Hypertension Guideline Management Algorithm published in JAMA
Contrast the 2014 (JNC-8) with The original 7th JNC hypertension guidelines discussed in your text. The full Guideline is available online at http://www.nhlbi.nih.gov/guidelines/hypertension/index.htm (Links to an external site.)
Please address ALL four situations presented below in your Case Study Response. A minimum of three credible (ie, research based, clinically relevant and published within past 4 years) APA formatted resources are required for this assignment.
You are practicing in a primary care office. You are seeing an obese (BMI 32) 50 year old man for a routine physical exam. He is not in acute distress. He has had two previous consecutive blood pressure readings of >148/92 (at two separate primary care visits) with patient quietly seated. Today is his third reading 158/94. No other co-morbid conditions are identified. What other diagnostic criteria would you require? What is your diagnosis–based on what criteria? What is your medication of choice for this patient (drug class, individual drug in class, dose, frequency and titration) and why–what is your rationale for this choice? What life-style changes are indicated? When would you like to see this patient in follow up?
In the event that your hypertensive patient has pre-existing asthma which class of drug, frequently used to treat hypertension may be contraindicated for him? What is your rationale?
Your hypertensive patient has now been diagnosed with diabetes, which antihypertensive class would be first choice for this patient be specific. What is your rationale for prescribing this/these drug(s)?
Your hypertensive patient has left ventricular dysfunction which antihypertensive drug class(s) would also benefit this patient? What is your rationale for prescribing this/these drug (s)?