Cardio Muscular Disease Case Study Summary

There are many risk factors that one should take into consideration. Having high blood pressure, being inactive and overweight are both very high risk factors. If a family member has diabetes or if a person is African, American Indian, Asian, Pacific Islander, Hispanic or Latino descent, they also have a greater risk of the disease.

What treatment options should be discussed with the patient? Provide a rationale for each potential treatment and how each is thought to impact the disease processes.

M.L. fits the first category with her T score of -2.7 to -3.4 so she should be receiving pharmacological treatment. According to Cosman et al. (2014), some of the recommended pharmacological treatments are bisphosphonates, calcitonin, an estrogen agonist/antagonist (raloxifene), or estrogen or hormone therapy. M.L. is currently on the bisphosphonate alendronate and may be considered for a once yearly dose of zoledronic acid (Reclast), also a bisphosphonate. Due to the family history of breast cancer in her mother, estrogen replacement was not considered, but as noted in the pharmacology section, raloxifene could be considered for M.L. if treatment with bisphosphonates was ineffective. There is no definitive recommendation for the length of treatment. It should be individualized based on risk factors and patient

Goal: Increase blood pressure and/or A1c control among patients with hypertension and/or diabetes in Hawai’i.

In evaluating M.T.’s medication regimen it is noted she is currently taking metoprolol 50mg twice daily and it is proven to be ineffective in managing her blood pressure which is currently noted as 174/94 with a pulse of 90. The metoprolol is a beta blocker and is not a first choice for a monotherapy to treat hypertension. The regimen is twice daily and creates complications for the M.T. to remember to take the medication. In addition, there is no documented history of heart failure or MI in M.T.’s medical history but there is

In response to your request regarding the therapeutics of adding Invokana (canagliflozin) or Jardiance (empagliflozin) to help lower Mr. Cramer-Martin blood glucose levels, we provide the following information:

A patient in their 70s with documented systolic heart failure and hypertension would need pharmacologic therapeutic intervention along with some lifestyle changes. To reduce the patient’s mortality rate, an ACE inhibitor and beta blocker should be prescribed. The ACEI would be given to reduce the preload and afterload (McCance and Huether, 2014). The beta blocker will assist the client by improving the left ventricular ejection fraction, slow the progression of heart failure, and increase exercise tolerance (Burchum and Rosenthal,

One of the diagnosis included hypertension also known as high blood pressure. If not treated over time hypertension can cause heart disease and stroke. In order, to lower blood pressure a person can consume a healthy diet with less salt, exercise daily and take their medication. Usually, if a person’s blood pressure is above 140/90 mmHg they are considered to have high blood pressure. My patient takes Lisinopril, it decreases blood pressure in hypertension, decrease preload, and afterload in cognitive heart failure. The only use for this is when a person has mild to moderate hypertension. Precautions for those who should not take this if you are pregnant, breastfeeding, or have renal disease. An adult can take this by mouth 10-40 mg/day and may be increased to 80

Hypertension. Of the individuals over the age of 18 diagnosed with diabetes, 71% had a diagnosis of hypertension (blood pressure of greater than or equal to 140/90) and used prescription medications to lower their blood pressure (CDC, 2014). Reduction in blood pressure was reported to decrease the risk of diabetic complications, such as heart attacks, strokes, blindness, and kidney failure (CDC, 2014).

The pressure in the blood vessel become too high and stay high for an extended period of time. This patient risk for heart attack, heart failure, stroke along with other health problems is increased due to the diagnosis of hypertension. The patient will measure blood pressure at home. Home monitoring of blood pressure helps individuals control/manage blood pressure. Home monitoring along with support from a provider per NCBI (2015) can help patient to lower blood pressure even more. Patient also needs to be taught how too correctly measure blood pressure at how using the correct size cuff (NIH, 2015). JNC 8 guidelines recommends thiazide diuretic as an initial treatment for hypertension in individual with diabetes or general African American population. If the blood pressure is not controlled in one month the medication should be increased or a second medication added (AAFP,

Based on the search and evidence, I would recommend the patient to use Lisinopril because it is cheaper compared to the other Ace-inhibitor because the patient doesn’t have insurance at least he can afford a medication.8. The recommended dosage for the patient would be taking lisinopril 5mg orally once daily for 2 days within 24 hours of acute myocardial infarction, then 10 mg orally once daily for at least 6 weeks. 8 Taking ACE-inhibitors have shown positive aspects for diabetes patients which can help improve their disease

cholesterol or high blood pressure, it will impact the recommendations given for a dietary plan.

Just about every five minutes two people die of diabetes related causes and 16 people are newly diagnosed with the disease (Centers for Disease Control and Prevention [CDC], 2015). Diabetes is becoming an increasingly prevalent disease, especially type 2, due to the fact that the United States population is at high risk for obesity. Type 2 diabetes is when the pancreas suffers a decline in beta cell efficiency therefore disallowing insulin to be produced at the level necessary for its metabolic function (CDC, 2015). As the incidence of diabetes increases, a positive correlation can be observed in increased risk of cardiovascular disease. According to the Centers for Disease Control (2012), in the 2011 population of people diagnosed with diabetes there were five million people with coronary artery disease, about two million who had a stroke, about 4 million diagnosed with another heart disease or condition, and about eight million diagnosed with heart disease or who have had a stroke. A person with diabetes is twice as likely to develop cardiovascular disease than a person who does not have diabetes (National Diabetes Information Clearinghouse [NDIC], 2005). The numbers of people being diagnosed with cardiovascular disease due to increased risk from already having diabetes is alarming and is a major burden of diabetes. Having diabetes affects the patient in many ways but the addition of cardiovascular disease only complicates the disease and the management of it for the

The management of diabetes mellitus (DM) is to eradicate symptoms and to minimize the development of complications (Khardori, 2014).The minimization of microvascular damages involving kidney and eyes can accomplished through managing glycemia and blood pressure (BP) (Khardori, 2014). The minimization of macrovascular damages, for examples: coronary, cerebrovascular, peripheral vascular, can be achieved by active control of lipids and hypertension (HTN), anticoagulant therapy, and glycemic control. The DM patient should maintain their glucose level close to near-normal levels of 90 to130 mg/dL and hemoglobin A1C (HbA1c) levels below 7% (Khardori, 2014). HbA1c should be evaluated every three to six months (Khardori, 2014).The DM patient’s BP should be maintained below 130/80 mm Hg, and even lower for the patient’s with DM nephropathy (Khardori, 2014). Low-density lipoprotein (LDL) goal of less than 70 mg/dL in patients with preexisting cardiovascular disease (CVD) or patients with the risk factors for coronary vascular disease (CVD) (Domino & Baldor, 2013).

In today’s fast paced environment in which we live, it is wise to maintain proper health through exercise, diet, and sleep. Often time that is easier said than done. A healthy heart is paramount to our existence, as it is the organ that pumps blood through the body via the circulatory system, supplying oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. Personally, I take great interest in the health of my heart because it needs regular monitoring on a weekly basis. I am prescribed medications by my physician for a variety of reasons, and these medications must be in balance with my height, weight, and heart rate. In fact, I must meet with my physician monthly.