International Journal of Clinical Case Reports 2024, Vol.14, No.3, 144-156 http://medscipublisher.com/index.php/ijccr 151 Table 1 Comparison of nutrient composition of low-sodium diet therapy with patient's requirements (Adapted from Hafid et al., 2021) Nutrient Requirement Intake % of Requirement Energy (kcal) 1740.4 1740.4 100% Protein (g) 65.2 65.2 100% Fat (g) 38.6 38.6 100% Carbohydrates (g) 282.8 282.8 100% Sodium (mg) 1000 1000 100% From Table 1, it can be seen that the patient's actual intake perfectly matches her nutritional requirements, achieving 100%. This indicates that the dietary intervention precisely met the patient's nutritional needs, contributing effectively to her health management. This case highlights the importance of providing personalized nutritional interventions for patients with chronic diseases and demonstrates how nutrition intervention and education can significantly improve the management of hypertensive patients. Furthermore, the case reveals that the healthcare team should include nutritionists and other health professionals working together to provide comprehensive disease management for the patient, which is a key factor in enhancing treatment outcomes. 5.3Case 3 In the study by Pinho-Gomes and Rahimi (2019), a 65-year-old male patient with a long history of hypertension developed heart failure (HF). Despite receiving antihypertensive treatment, the patient continued to exhibit symptoms related to heart failure, such as shortness of breath and decreased exercise tolerance, with consistently high systolic blood pressure. The treatment strategy employed a combination of multiple medications to address both hypertension and heart failure. Key medications included beta-blockers, ACE inhibitors, and mineralocorticoid receptor antagonists. The target blood pressure was set at 130/80 mmHg to balance the risk of hypertension and the potential exacerbation of heart failure symptoms due to excessively low blood pressure. Throughout the treatment, the patient's symptoms significantly improved, and systolic blood pressure stabilized within the target range. Follow-up echocardiography showed an improvement in ejection fraction, and the patient reported enhanced quality of life and increased physical activity levels. Regular monitoring was crucial to adjusting medications and dosages, ensuring optimal control of both hypertension and heart failure. This case highlights the complexity of managing blood pressure in patients with coexisting hypertension and heart failure. Clinicians should adopt a cautious blood pressure management strategy, focusing on individualized treatment plans based on the patient's specific condition and continuously evaluating the effectiveness of the treatment. Additionally, the case underscores the importance of patient education and adherence to the medication regimen for successful management. 6 Challenges and Considerations 6.1 Patient adherence to treatment plans Adherence to antihypertensive medications is a critical component of effective long-term management of hypertensive heart disease (HHD). Several factors can impact patient adherence, including complex medication regimens, side effects, and lack of understanding of the disease and its consequences. Socioeconomic factors, such as cost of medications and access to healthcare, also play a significant role. Moreover, psychological factors, including depression and stress, can further reduce adherence to treatment plans (Ayodapo et al., 2018). To improve compliance, healthcare providers can implement several strategies. Simplifying medication regimens, using fixed-dose combinations, and providing clear instructions can enhance adherence. Patient education about the importance of consistent medication use and lifestyle modifications is crucial. Regular follow-up and support
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