Jim is a mildly overweight, 55-year-old patient who, in the past year had several elevated blood pressures, ranging from 140-150 systolic / 70 to 80 dystolic. He is coming to see you for a check-up because he is experiencing an increase in headaches. Jim has a family history of hypertension and diabetes, and his father had a heart attack at age 60. He has health insurance. In talking with Jim, you find that he has been more stressed lately because of increasing responsibility resulting from a job promotion. He is also feeling a lot of tension with his 16-year-old son. He sees himself as fairly healthy, but has concerns about his family history of heart disease. He wonders if his headaches are due to stress or to high blood pressure, and should he start medication.
How would you respond to Jim?
Consider the problems with only applying a conventional perspective
Examine the benefits of recommending non-pharmacologic methods
Whether you choose to recommend to Jim that he start with one or more lifestyle modifications, a hypertensive medication, or combination method, you will need to closely monitor Jim's blood pressure and to assess both potential side effects and/or success with any of the interventions selected.