case study Hypertension

May 29th, 2015
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University of Iowa
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Initial treatment for her diabeteshas been consisted of oral sulfonylurea with the rapid addition of metformin.Herdiabetes has been under fair control wih a most recent hemoglobin A1c of 7.4%

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Case study : TREATING Hypertension inPatients with DiabetesPatients with DiabetesPresentationM,s is a 55-years old white woman with history of typt 2 diabetes ,obesity,hypertension ,and migraine heardaches.The patient was diagnosed with type2diabetes 9 years ago when she presented with mild polyuria and polydipsia m,sIs 54 and has always been on the large side,with her weight fluctuated between165oe 185 lb.Initial treatment for her diabeteshas been consisted of oral sulfonylurea with therapid addition of metformin. Herdiabetes has been under fair control wih a mostrecent hemoglobin A1c of 7.4%Hypertnsion wasdiagnosed 5 years ago when blood pressure( BP) treatedmeasured in the office was noted to be consistently elevated in the range of160/90 hhmg on three occasions.m,s was initially treated with lipinopril ,startingat 10mg daily and increasing to 20mg daily,yet her BPcontrol has fluctuated.One year ago,microalbuminiria was detected on an annual urine screen,with1.943ml/dl of microalbumin identifiedon a spot urine sample m,s comes into theoffice today for her usual follow-up visit for diabetes.Physical examination revealsan obesewoman a BP of 154/86 mmHg and a pulse 78 bpm.QUESTIONS1.What are the effctes of controlling BPin people with diabetes2.what is the target BPfor patients with diabetes and hypertension3.Which antihypertensive agents are recommended for patients with diabetesCommataryDiabetes mellitus A major risk factors for card

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