You are working in the hospital medical ward and start your morning assessments. Mr. HAPPY is a 50-year-old accountant who was admitted 2 days ago to hospital following a blackout whilst watching a football match with his son. His preliminary examination reveals bruising to his left arm and upper thigh for which he has been prescribed paracetamol 1 g four times daily and as required ibuprofen 400 mg three times a day. His past medical history indicates that he is on no medication and seemed to be a reasonably fit man for his age with no existing diagnosed medical conditions On examination he is slightly overweight at 81 kg. he smokes 20 cigarettes per day and drinks approximately 30 units of alcohol per week, His blood pressure on admission was 165/80 mmHg with a heart rate of 90 beats per minute This degree of raised blood pressure and heart rate has been maintained over the last 48 hours. He is subsequently diagnosed as having hypertension.


1. What is hypertension?

2. What are the appropriate treatment targets for this patient’s blood pressure?

3. Besides blood pressure, what other advice and treatment does this patient require to ensure hIS risk of a cardiovascular event is reduced? Give clear reasons for your advice and explain the risks associated with not taking this advice.

4.What are the main classes of drugs used to treat hypertension?

5.Which class of drug would be the appropriate first-line treatment for Mr. HA? How would this treatment choice be affected if the patient had been of Afro Caribbean origin?

6. For one of the classes of drugs mentioned in question4 indicate the following a drug from that class a suitable starting dose and frequency the maximum dose for hypertension three contraindications three common side-effects.

7. In view of Mr. HA’s age he requires a cardiovascular risk assessment. How would you assess this patient’s cardiovascular risks?

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