Independent Nurse: Clinical - Hypertension - Prescribing for hypertension.

CASE STUDY

Treating hypertension usually involves more than one drug. Dr David Morris examines such a case.

Brian Johns is a 51-year-old sales team manager of a thriving pharmaceutical company. His attendance at surgery was triggered by a company medical screen, which had shown 'very high' blood pressure and cholesterol readings.

Brian was directed to the practice nurse, who measured his blood pressure (BP) as 182/114mmHg, the lower of two readings. The nurse arranged for a set of bloods (U&E, fasting glucose and lipids) and an ECG. She also discussed lifestyle measures to reduce blood pressure and asked Brian to make a follow-up appointment with the GP.

Brian was overweight, with a BMI of 31 - a problem no doubt fuelled by corporate entertainment and a hotel food diet on his frequent business trips. Although he had been a keen sportsman in his younger days, his regular …