Concluded Case

Hypertension in young patient

A 29yrs old male, my friend I checked BP casually. It was 210/120. So on friendly note recommending heart screening and got tests done. His lipid profile was 765 too high... no other abnormality. Not having any symptoms. But 2D echo is as below... can someone guide apart from BP control what care has to be taken?

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secondary HTN was rules out, did TMT urine VMA, Renal doppler was done... everything was normal. so started on HTN medication Met XL 50mg and BP is under control.

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He is a c/o malignant hypertension with dislipidimia 2decho suggest gr 2 diastolic dysfunction which is significant as well as apical lt ventricular hypertrophy All findings need to be adress He needs ecg stress test Detailed cholestrol HDL tg and lipid profile Control wt and obesity and BMI Rx tab telmisartan -ct 40+12.5 mg 1od Tab metaprolol 50mg 1od at bedtime Tab ecosprin 150mg 1od Rest of treatment after complete investigations

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Accelerated hypertension Adv renal Doppler Fundoscopy Urine microalbumin, VMA See BMI , TFT, hba1c. Complete lipid profile. rule out metabolic syndrome. Salt restriction,Diet and exercise Plan Gradual reduction in BP. See for familial hypertriglyceridemia.

MALIGNANT HYPERTENSION.. WITH.. ? HYPERLIPIDEMIA.. NEED'S.. CARDIAC PROFILE.. ECG..2D ECHO STUDY.. ANTIHYPERTENSIVE MEDICATIONS AS PER REQUIREMENT.. ANTI HYPERLIPIDEMIC AGENTS.. ATORVASTATIN .. ROZUVASTATIN.. DIET PLAN.. SMALL..FREQUENT .. DIET .. FRUITS AND VEGETABLES.. LOW FAT.. DIET .. FIBRES RICH FOOD.. REGULAR EXERCISE..

Tnx Dr Shivraj Agarwal sir
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Pl post his ecg.in lipid profile 765 is what?. Triglycerides. Pl go for his renal doppler as well.is he obese? .u can start him tab staml 5mg 8am & tab telista ch 40+12.5mg 8pm.pl keep a watch on his blood pressure. Our target to achieve is 130/ 80.u can adjust the dose of anti hypertensive drugs

Young hypertensive with accelerated hypertension , LVH and dyslipidemia Secondary causes of HTN Conn's syndrome Pheochromocytoma Renal artery stenosis Glomerular pathologies Need to rule out with investigations . Dyslipidemia should be evaluated and as sir mentioned metabolic syndrome , fatty liver should be addressed . As patient is young, bad habits like smoking , drinking or tobacco use also should be stopped immediately if history suggests so.

Accelerated Htn Need regularly monitoring of Bp Advise life style modification most important Then avoid alcohol intoxication Start with tab.nexovas 10 mg daily once Tab. Atormac gold 20 mg daily one afternoon Tab.razo 20 mg daily one bbf Tab.evion 400 mg daily one night

secondary HTN was rules out, did TMT urine VMA, Renal doppler was done... everything was normal. so started on HTN medication Met XL 50mg and BP is under control.

ejection fraction????

Thanks for ur appreciation dr dinesh gupta..
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