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A 50-year-old caucasian female who is overweight (BMI 29.5) and does not take any medications except for a multivitamin. She denies tobacco use but admits to drinking 2-3 cocktails in the evening to “unwind.” She states that both her father and brother have hypertension, and her paternal grandfather had a “heart attack” and stroke around age 55. She states that she has been having occasional morning headaches (3/10), which dissipate within about 1 hour of awakening. Because of these headaches, she started monitoring her BP at her local CVS and has brought you the following BP log: Day #1: 145/92. Day #2: 153/88 Day #3: 139/94 Day #4: 142/90 Day #5: 152/89 Today’s vitals are: BP 162/94 mmHg; HR 82 bmp; RR 15.Â
1. What are your differential diagnoses? 2. What other questions would you ask this patient? 3. What diagnostic testing would you perform? 4. Discuss your non-pharmacological and pharmacological recommendations and provide a rationale.
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