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Apr 27, 2023
      • Please develop or make up your own, original case study regarding a person with Hypertension with 5 questions and answers. Here is an example study that is supposed to be used to work from, but should not be copied.


        Sample case of Ted — Don’t use this exact case!

        About one in three adults faces high blood pressure or hypertension. Blood pressure is the force of blood against artery walls and it is assessed in millimeters of mercury. Blood pressure tells us how the heart is working and the condition the arteries are in.

        Ted, a 64-year-old, banking executive has hypertension, and he needs to make significant nutrition and lifestyle changes, as his hypertension is contributing to his risk for heart disease. He typically eats on the go and there are lots of sweets in the break room at work, all the time. Some of his younger coworkers are junk food junkies and heavy snickers. Ted is 25 pounds overweight and has recently quit smoking, and he’s hungry all the time. His father had hypertension and died of a heart attack, so his perceived threat of this problem is high. However, he does not feel comfortable that he can make the necessary dietary changes to improve his eating and help him lose weight. He is coming to you, as part of the wellness team at his bank (or company) for education, support and help.

        Please answer the following questions to discuss how you might be able to help Ted.

        Where might Ted’s systolic blood pressure be if he has either Stage 1 or Stage Two of hypertension and what might be his Diastolic Blood Pressure? What are systolic and diastolic blood pressure? What is optimal blood pressure?
        What are some causes of hypertension? What is primary hypertension?
        And, what are some risk factors for hypertension?
        What type of health education (health facts) might you provide Ted to educate him about hypertension? What lifestyle changes can Ted make?
        Explain the DASH Diet to Ted. Please also be sure to include a few sentences showing how you would encourage Ted to use the DASH diet.

        Sample answers:

        Stage 1 – Ted’s systolic blood pressure would be 140-159 and his diastolic blood pressure would be 90-99. Stage
        2 – Ted’s systolic blood pressure would be greater than or equal to 160 and his diastolic blood pressure would be greater than or equal to 100. The systolic blood pressure is the higher number. It is the pressure in the arteries when the heart beats. The diastolic blood pressure in the arteries when the heart relaxes. Optimal blood pressure is 120 over 80 mm Hg.
        Some causes of hypertension are kidney and liver disease as well as diabetes and they can cause Stage 2 Hypertension. Primary hypertension occurs when over years there are changes in the arteries, kidneys and sodium/potassium balance. Arteries harden and narrow and face damage as we age. Blood pressure increases as the arteries age and harden and the kidneys can release increased renin, causing the release of onother chemical that is a vasoconstrictor. Diets high in sodium or low in potassium worsen physiological changes that occur as we age.
        3. Risks for high blood pressure include age, race, obesity and having diabetes. Increased age, being obese and having diabetes cause risk for hypertension. And African Americans are more prone to hypertension than whites. High blood pressure over time further damages the arteries and can increase the risk of heart attack, stroke, kidney disease, dementia and vision loss. Some might mention pregnancy and lead exposure as risks for high blood pressure.
        4. I would educate Ted about the risks of his being obese and not eating a diet high in fruits and vegetables. I would let him know of the hardening of his arteries as he ages and how high blood pressure can further complicate damage to arteries. High blood pressure is associated with stroke and heart attacks as well as dementia and vision loss. If Ted wants to stay healthy and avoid health risks to enjoy his life he needs to make lifestyle changes that will help him by exercising regularly, with moderate exercise five days a week for 45-60 minutes. He needs to cut his high-fat diet and empty calorie sweets. He can bring healthy snacks to work so that he can still visit in the break room. Ideas for healthy snacks include low-fat yogurt, fruit salad mixes, and vegetables with low-fat salad dressing. He also needs to stop salting his food heavily and reduce his sodium intake. His sodium intake needs to be at or below 2400 mg per day. Also, Ted needs to lose weight. Even a modest weight loss will help with hypertension. But, if he can eventually get to a healthy or average weight for his height, this should be a goal. Finally, in terms of meals, he needs to minimize his intake of sweets, sugary drinks and red meat, replacing this with lean protein and lots of fruits and vegetables.
        5. The DASH diet is great for helping one make lifestyle change. I might begin to encourage Ted by saying that the DASH diet could be a beginning of his road to change and could thus “jumpstart” his lifestyle change! I would let him know that the DASH diet is very effective and it is as effective as drugs to reduce hypertension in some studies. It is a diet that could also help other members of his family. I would explain that the DASH diet is low on carbs and fat and high fruits, veggies and low-fat dairy and lean proteins. It is a great lifestyle change diet. Following the DASH diet will improve his nutrient intake and help him increase his fiber intake. I would encourage him to develop a meal plan high in fruits and veggies with lean meats like poultry and fish. And, of course, low-fat dairy products.

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