International Journal of Clinical Case Reports 2024, Vol.14, No.3, 144-156 http://medscipublisher.com/index.php/ijccr 150 4.2.2 Importance of diet and exercise Maintaining a healthy diet and regular exercise regimen is essential for the long-term management of hypertension. These non-pharmacological strategies not only help in lowering blood pressure but also in managing other risk factors such as obesity and diabetes. Studies have shown that patients who adhere to lifestyle modifications have better blood pressure control and reduced cardiovascular risk (Hall et al., 2021). Stress management and ensuring adequate sleep are also important as chronic stress and poor sleep can negatively impact blood pressure and overall health (Sung et al., 2018). 4.3 Monitoring and follow-up Regular monitoring of blood pressure is crucial for the effective management of HHD. Home blood pressure monitoring allows for better tracking of blood pressure trends and can help in adjusting medications promptly to achieve optimal control. Patients should be educated on the correct technique for home monitoring and encouraged to keep a log of their readings (Mills et al., 2018). Periodic cardiovascular assessments are necessary to monitor the progression of HHD and to detect any complications early. These assessments may include regular check-ups, blood tests, and imaging studies such as echocardiograms to evaluate cardiac function and structure. Regular follow-ups with healthcare providers are essential to adjust treatment plans as needed and to manage any comorbid conditions effectively (Benenson and Bradshaw, 2021). 5 Clinical Case Analysis 5.1Case 1 A 65-year-old male with a 20-year history of hypertension presented with progressive shortness of breath and occasional chest pain. Physical examination revealed elevated blood pressure (160/100 mmHg) and an enlarged heart on chest X-ray. Echocardiography confirmed left ventricular hypertrophy (LVH) with a left ventricular wall thickness of 15 mm and preserved ejection fraction (Fragoulis et al., 2021). The patient was prescribed ACE inhibitors (lisinopril), beta-blockers (metoprolol), and diuretics (hydrochlorothiazide) to control blood pressure and reduce cardiac workload. Additionally, he was advised to adopt the DASH diet and engage in regular physical activity, such as brisk walking for 30 minutes daily. This case underscores the importance of early diagnosis and aggressive management of hypertension to prevent LVH and associated complications. Combination pharmacotherapy and lifestyle modifications are essential for effective long-term management of HHD. 5.2Case 2 Hafid et al. (2021) focused on a 55-year-old female resident of Palu City, Central Sulawesi. The patient was treated for hypertensive heart disease (HHD) at the Udjatapalu Regional Public Hospital. Her symptoms included chest pain, palpitations, shortness of breath, cold sweats, and nausea. She had a high salt intake in her diet and a family history of hypertension. During treatment, her diet was adjusted to a low-sodium diet in soft food form, with three main meals and two snacks per day, all administered orally. Additionally, to enhance her awareness of disease management and improve dietary choices, she received targeted nutritional education. The study explored the effectiveness of a customized low-salt diet on her health by monitoring her food intake, biochemical tests, weight and height measurements, and clinical evaluation of her physical condition. The results showed that after implementing the low-sodium diet, her food intake improved (Table 1), her nutritional knowledge increased, and there was no change in her weight. Furthermore, the dietary intervention administered orally led to positive changes in food intake, as well as physiological and nutritional status.
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