The document outlines a case study of a 65-year-old female diagnosed with primary hypertension, characterized by elevated blood pressure and symptoms such as headache, giddiness, and vomiting. It includes her medical history, assessments, and the recommended treatment regimen, which involves medication and lifestyle modifications to manage her condition. The document emphasizes the importance of addressing risk factors and adopting a healthier lifestyle to mitigate the effects of hypertension.

1. Presented By : Prasidhi S. Singh
S.Y. D. Pharm
Guided by : Swati G. Patil
K. Y. D. S. C. Ts College of Pharmacy ,
Sakegaon .

2. Case Study
A 65 year old female , resident of Mumbai , reported to the clinic on
30/10/2022 , with frequent episode of mild headache with giddiness in
morning and episode of vomiting .
Past medical history :
• 1 month ago she had admitted in hospital with fever
and slightly increase B.P.
• Some year ago she had produces illness .
Family history :
No family history found.

3. Physical Examination
CVS : S1S2 heard
B.P : 150/90 mmHg
Diagnosis
Biochemical investigation
Test Report Normal
Value
Serum
creatinine
1.8 mg/ml
RBS 111 mg/dl (70-140
mg/dl)
Blood Urea 63 mg/dl (15-40
mg/dl)
B.P. checked by
sphygmomanometer

4. Hematological Report
Test Repost Normal value
White blood cells 9,300 cell/cu (4000-11000
cell/cu.mm)
Neutrophils 73 % (40-45 %)
Eosinophil 02 % (1-8 %)
Monocytes 05 % (2-10 %)
Haemoglobine (Hb) 12 gm % (12-16gm%)

5. SOAP analysis
Symptoms ( subjective )
• Headache
• Giddiness
• Vomiting
Objective
• B.P. : 190/110 mmHg
Assessment
Based on symptoms and objective evidence this case is assessed
Primary Hypertension .

6. Hypertension
Hypertension is condition in which Systolic blood pressure greater than 140 mmHg and
diastolic blood pressure greater than 90 mm Hg . Hypertension ̶ or elevated blood pressure ̶
is a serious medical condition that significantly increases the risks of heart, brain, kidney and
other diseases.
High blood pressure is classified as
1. Primary (essential) hypertension
About 90–95% of cases are primary, defined as high blood pressure due to nonspecific
lifestyle and genetic factors i.e. excess salt in the diet, excess body weight, smoking,
and alcohol use.
2. Secondary hypertension : 5–10% of cases are secondary, defined as high blood
pressure due to an identifiable cause, such as chronic kidney disease, narrowing of
the kidney arteries, an endocrine disorder, or the use of birth control pills.

7. Angio
tensin
I
Angio
tensin
II
AT1 Receptor present
on wall of blood vessel
Constrict
Hypertension
blood
vessel
ACE (present on
Heart , lungs , blood
vessel
AT1 Receptor
adrenal gland sodium and
Water retention
Blood
Volume
How to produce
hypertension
Produce

8. Reasons Of Hypertension
Blood volume
increases
Heart Rate
increases
Stroke volume
increases
Blood viscosity
increases
Peripheral resistance
increase
Increase Blood Pressure

9. Symptoms
Of
Hypertension
Dizziness
Irregular heart beat
Headache
Fatigue
vision changes
Buzzing in the ears
Vomiting
Anxiety

10. Treatment
Drug Name Dose Frequency
Tab – Losartan
potassium
hydrochlorothiazide
50 mg
+12.5 mg
1 – 0 - 0
Tab- Ranitidine 150 mg 1 – 0 - 1
First line: The first line therapy is CCB or ACE inhibitors
Second line : ACE With TD
Note (Use ARBs , If the patient intolerance to ACE inhibitor)

11. Contraindications
/ (Don'ts)
Pregnancy
Renal Failure
Aortic valve stenosis

13. Lifestyle modification for all grade
hypertention:
 Salt restricted diet (< 2.4 gm /day ) , low fat diet ,
weight reduction if over weight
 Physical activity like brisk walking
 Avoid alcohol consumption and smoking .
 Maintain Healthy weight .
Storage of medication :
Protect from sunlight and store in normal
temperature