Posted: March 31st, 2023

High Cholesterol Case Study: Diagnoses and Comprehensive Care

High Cholesterol Case Study. A 61-year-old Black male with a history of hypertension presents to your clinic for complaints of headaches and blurred vision x 4 days. He denies any weakness, numbness, chest pain, shortness of breath, palpitations, or recent, illicit drug use. He states he has been compliant with his medications (hydrochlorothiazide and metoprolol), and he took his meds this morning.
His V/S include: B/P 190/100, P- 90, T- 98.9, R- 22. Recent labs show that Total Cholesterol- 260, LDL-190, HDL- 35, Triglycerides- 320. He did not return for these results and did not start any new meds.
What are your diagnoses and include rationales with references:
1-Hypertension:
2-Hypercholesterolemia:
3-Hypertriglyceridemia:
Write plan of care for this patient?
What is the treatment pharmacologic (with references)
What is non-pharmacologic treatment/education/follow up.
Expectations

APA format with intext citations
Word count minimum of 250, not including references.
References: 2 high-level scholarly references within the last 5 years in APA format.
Plagiarism free.
Turnitin receipt.

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High Cholesterol Case Study: Diagnoses and Comprehensive Care

In the presented case study, a 61-year-old Black male with a history of hypertension complains of headaches and blurred vision. A thorough analysis of his medical history, vital signs, and recent lab results highlights the need for a comprehensive diagnosis and an effective plan of care. This article delves into the diagnoses and offers evidence-based rationales, treatment approaches, and education/follow-up recommendations.

Diagnoses and Rationales:

Hypertension: The patient’s elevated blood pressure (B/P 190/100 mmHg) falls above the hypertensive range, indicating uncontrolled hypertension. Hypertension is a significant risk factor for cardiovascular diseases, including stroke and heart disease. The patient’s history of hypertension, non-adherence to medication, and elevated blood pressure measurements provide evidence for this diagnosis (American Heart Association, 2017).

Hypercholesterolemia: The patient’s lipid profile reveals elevated Total Cholesterol (260 mg/dL) and LDL levels (190 mg/dL), surpassing the recommended levels. Hypercholesterolemia, characterized by high levels of cholesterol, is a risk factor for atherosclerosis and cardiovascular diseases. The patient’s lipid profile values align with the diagnostic criteria for hypercholesterolemia (Grundy et al., 2019).

Hypertriglyceridemia: The patient’s elevated Triglycerides level (320 mg/dL) suggests hypertriglyceridemia. High triglyceride levels are associated with an increased risk of cardiovascular diseases. The patient’s triglyceride value exceeds the recommended range, supporting the diagnosis (Miller et al., 2018).

Plan of Care:

Pharmacologic Treatment: The patient requires antihypertensive medication adjustments to achieve blood pressure control. A combination of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) with diuretics, as well as beta-blockers, could be considered (Whelton et al., 2018).

Hypercholesterolemia Treatment: Initiate statin therapy to manage elevated LDL cholesterol levels. Statins effectively lower cholesterol and reduce cardiovascular risks. A high-intensity statin regimen, like atorvastatin or rosuvastatin, is recommended due to the patient’s high LDL levels (Grundy et al., 2019).

Hypertriglyceridemia Treatment: Lifestyle modifications should be the initial focus. Incorporate dietary changes, regular exercise, and alcohol moderation to lower triglyceride levels. Omega-3 fatty acid supplements could be considered for further triglyceride reduction (Miller et al., 2018).

Non-Pharmacologic Treatment/Education/Follow-Up:

Lifestyle Modifications: Emphasize the importance of a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Encourage the patient to limit saturated and trans fats, as well as added sugars. Regular aerobic exercise, such as brisk walking, can contribute to overall cardiovascular health.

Medication Adherence Education: Stress the significance of adhering to prescribed medications consistently. Explain potential benefits, side effects, and the necessity of regular follow-up appointments for dose adjustments and monitoring.

Follow-Up: Schedule regular follow-up appointments to monitor blood pressure, lipid levels, and medication adherence. This provides opportunities for healthcare providers to assess progress, adjust treatments, and provide additional education.

In conclusion, this case study underscores the importance of a holistic approach in managing hypertension, hypercholesterolemia, and hypertriglyceridemia. By addressing both pharmacologic and non-pharmacologic interventions, healthcare providers can optimize patient outcomes and mitigate cardiovascular risks.

References:

American Heart Association. (2017). Hypertension. https://www.heart.org/en/health-topics/high-blood-pressure

Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., Goldberg, R., Heidenreich, P. A., Hlatky, M. A., Jones, D. W., Lloyd-Jones, D., Lopez-Pajares, N., Ndumele, C. E., Orringer, C. E., Peralta, C. A., … & Robertson, R. M. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline on the Management of Blood Cholesterol. Journal of the American College of Cardiology, 73(24), e285-e350.

Miller, M., Stone, N. J., Ballantyne, C., Bittner, V., Criqui, M. H., Ginsberg, H. N., Goldberg, A. C., Howard, W. J., Jacobson, M. S., Kris-Etherton, P. M., Lennie, T. A., Levi, M., Mazzone, T., Pennathur, S., Wanner, C., & Triglycerides, C. G. D. L. (2018). Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 138(19), e484-e523.

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., … & Smith, S. C. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal of the American College of Cardiology, 71(19), e127-e248.