A 5'6", 210 pound, 64 year old man had a physical exam prior to his retirement for corporate work. His blood pressure was greater than 180/115 mmHg on three separate days (normal blood pressure is 120/80). Further examination showed normal to low plasma renin activity, elevated systemic vascular resistance (SVR), x-ray showed left ventricular hypertrophy and retinal hemorrhage and cardiac output was 7.2 L/min (normal is 3.5 to 5.5 L/min). Recommended therapy was weight reduction to his ideal weight, low salt diet. If these life style changes did not change his condition the following medication will be started in the following order: oral diuretics progress to beta blockers and then to a vasodilator. 1) What is the diagnosis for this individual?
2) Why is it suggested that the patient go on a low sodium diet?
3) Explain the site and mechanism of action of each of these prescribed medications. Include in your discussion how each of these medication would improve the patient’s condition (be specific)
a) oral diuretic:
b) beta-blocker:
c) vasodilator like an alpha 1 blocker:
d) angiotensin converting enzyme inhibitor (ACEI) 3) Define and indicate the cause of the ventricular hypertrophy?
4) What was the cause of the retinal hemorrhage?