Journal name: World Journal of Pharmaceutical Research
Original article title: Accelerated hypertension in diabetes & ckd comorbidity
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: a case report
Original source:
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Varun Lal, Sharad Chand
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World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Accelerated hypertension in diabetes & ckd comorbidity
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20189-12279
Copyright (license): WJPR: All rights reserved
Summary of article contents:
Introduction
Malignant hypertension is a severe form of hypertension characterized by blood pressure exceeding 200/100 mmHg, often associated with multi-organ ischemic complications. This condition can stem from primary or secondary hypertension, and accurately differentiating between the two is crucial for effective treatment. The case report discusses a 52-year-old woman who presented with accelerated hypertension alongside diabetes mellitus (DM) and chronic kidney disease (CKD), illustrating the complexities involved in managing such co-morbidities.
Accelerated Hypertension: A Complicated Condition
This case highlights the challenges associated with accelerated hypertension, especially when compounded by conditions like CKD and diabetes. The patient arrived at the hospital exhibiting severe hypertension and acute renal failure, with blood pressure readings as high as 200/110 mmHg. After emergency management with parenteral antihypertensives, the patient's blood pressure improved significantly, underscoring the need for prompt intervention in cases of accelerated hypertension to prevent further organ damage.
Diagnostic Challenges
Identifying the underlying causes of accelerated hypertension can be particularly complex, especially when acute renal failure is present. Factors that contribute to secondary hypertension include renal parenchymal issues like chronic glomerulonephritis, renal artery stenosis, endocrine conditions such as hyperthyroidism, and pregnancy-related complications. This case serves as a reminder of the importance of thorough evaluation and accurate diagnosis to guide treatment options effectively and improve patient outcomes.
Treatment and Management
The management of the patient involved a combination of medications tailored to stabilize her condition and address her underlying health issues. Initial treatment included parenteral labetalol, along with oral medications such as amlodipine, gliclazide, and atorvastatin. The transition from emergency treatment to long-term management is crucial for ensuring adherence to medication regimens and mitigating the risk of future complications. This case emphasizes the need for comprehensive treatment strategies to manage multiple comorbidities effectively.
Conclusion
The reported case underscores the critical nature of accurately diagnosing and treating accelerated hypertension, particularly when it coexists with conditions like diabetes and CKD. With timely medical intervention and a well-structured follow-up plan, the patient was stabilized and discharged after five days. Ongoing research and clinical awareness regarding the challenges of managing accelerated hypertension are essential for improving patient outcomes and reducing morbidity and mortality associated with this condition.
FAQ section (important questions/answers):
What is malignant hypertension and its characteristics?
Malignant hypertension is a severe form of hypertension, typically over 200/100 mm Hg, leading to multi-organ ischemic complications. It remains stable in incidence but has lower mortality due to improved antihypertensive therapies.
What are common secondary causes of accelerated hypertension?
Secondary causes include renal issues like chronic glomerulonephritis, renal artery stenosis, hormonal disorders such as hyperthyroidism and pheochromocytoma, and pregnancy-related conditions like preeclampsia.
What were the main symptoms presented by the patient?
The 52-year-old female patient presented with giddiness, headache, and vomiting, along with a significantly elevated blood pressure reading of 200/110 mm Hg.
How was the patient's hypertension treated in the hospital?
Emergency treatment included intravenous Labetalol, along with oral medications like Amlodipine and Gliclazide. The aim was to stabilize blood pressure and manage other comorbidities.
What recommendations were made for preventing accelerated hypertension?
Lifestyle modifications and strict medication adherence are crucial in preventing accelerated hypertension, alongside prompt diagnosis and treatment to avoid organ damage.
What follow-up care was recommended after patient discharge?
After discharge, the patient was advised to continue medications and return for a follow-up appointment in 15 days to monitor her condition and adjust treatment as necessary.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Accelerated hypertension in diabetes and ckd comorbidity”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Blood:
Blood is a vital fluid in the body and is indicative of various health conditions when analyzed. In the context of the case report, blood pressure readings and serum levels provided critical information regarding the patient’s health status, particularly concerning hypertension and chronic kidney disease.
2) Pulse:
Pulse refers to the rhythmic expansion and contraction of arteries as blood is pumped by the heart. Monitoring pulse rate can help assess cardiovascular health. In the case presented, pulse regularity and rate were significant indicators of the patient's overall condition during the emergency evaluation.
3) Karnataka:
Karnataka is a state in India where the reported case took place. The geographic location is relevant for understanding healthcare accessibility, local medical practices, and the demographic characteristics of patients in that region, influencing their medical treatment and presentation of diseases.
4) Disease:
Disease refers to a pathological condition of a bodily part, an organism, or system resulting from various causes. The case report highlights the interrelation of several diseases, including hypertension, diabetes mellitus, and chronic kidney disease, showcasing the complexities involved in patient diagnosis and management.
5) Drug:
The term drugs encompasses all therapeutic agents utilized in the treatment plan described in the report. Proper management of the patient’s conditions involved a careful selection of antihypertensives, antidiabetics, and other medications, highlighting the complexity of pharmacotherapy in multi-morbid patients.
6) Young women (Young woman):
The term 'young woman' describes the demographic profile of the patient. Though aged 52, her presentation characteristic emphasizes that such serious conditions can occur even in middle-aged individuals. It underscores the need for vigilance in screening for hypertension and its complications in adults.
7) Observation:
Observation refers to the monitoring of clinical parameters and patient progress. In this case, continuous observation was necessary to assess the effectiveness of treatment, recognize complications, and ensure the safety and stability of the patient over her hospital stay, which was critical to her recovery.
8) Discussion:
Discussion in medical case reports typically involves analyses and interpretations of findings, treatment efficacy, and possible implications for practice. In this report, the discussion highlights the importance of prompt diagnosis and treatment of accelerated hypertension to prevent adverse outcomes.
9) Vomiting:
Vomiting is a symptom that can indicate various health issues, including distress due to high blood pressure. In the presented case, the patient experienced vomiting, which may have been a result of elevated pressure and consequent organ distress, illustrating the need for comprehensive symptom management.
10) Teaching:
Teaching refers to the educational aspect of healthcare. In the context of this report, it relates to educating healthcare professionals about recognizing and managing accelerated hypertension effectively, promoting better outcomes for patients through improved knowledge and skills in clinical practice.
11) Sharad (Sarad):
Sharad is likely one of the authors of the case report, indicating his contribution to clinical research. The involvement of multiple healthcare professionals emphasizes the collaborative nature of medical case reporting and the multi-disciplinary approach often required in complex patient cases.
12) Family:
Family members often provide essential health histories and psychosocial support to patients. In this report, the family's role in communicating the patient’s background about chronic conditions underscores the importance of familial input in managing complex medical cases.
13) Chand:
Chand is another author in the report, further exemplifying the collaborative efforts present in research and clinical documentation. Having multiple contributors enhances the credibility of the findings and recommendations, emphasizing shared responsibility for improving patient care and outcomes.
14) Sugar:
Sugar, particularly in reference to blood glucose levels, is a critical parameter in managing diabetes mellitus. In this case report, the patient’s sugar levels were monitored to assess her diabetic control, which is crucial for preventing complications in patients with concurrent diabetes and hypertension.
15) Food:
Food is essential for providing nutritional sustenance but can also impact health conditions. In the case, the mention of vomiting food indicates the patient’s gastrointestinal response related to her acute medical situation, reminding healthcare providers of the interactions between diet, medication adherence, and health.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Accelerated hypertension in diabetes and ckd comorbidity’. Further sources in the context of Science might help you critically compare this page with similair documents:
Diabetes mellitus, Lifestyle modification, Case presentation, Chronic Kidney Disease, Medication adherence, Electrocardiograph, Primary hypertension, Secondary hypertension, Oral Hypoglycemic Agent, Preeclampsia and eclampsia, Renal artery stenosis, Malignant hypertension, Investigation Findings.