it, she complained about dizziness and how she was stressed. Her husband had a myocardial infarction 2 weeks prior to her visit and she was concerned about her blood pressure. She also had run out her prescription for Diovan HCT for hypertension, but resumed taking it the day of the exam. She also has gained excessive weight after January 2000 when she was 163 pounds. She has gained 13 pounds since then and currently weighs 176 pounds. She has had normal cholesterol, high and low-density lipoproteins, and triglycerides on her last visit. Her blood glucose has been normal.Significant Hospital and Clinic EventsI.1987-hysterectomy for cervical cancerII.Jan. 25, 2000- Mammogram abnormality indicated in left breastIII.Feb. 4, 2000-Left breast biopsy done as same day surgeryIV.Feb. 20, 2000-Indicated as fibrocystic disease breast disease (benign)V.June 20, 2000- Orthopedist concluded a whole body scan needed due to multiple areas of tenderness; exact etiology difficult to identify.VI.July 15, 2000- Indicated osteoarthritis present and degenerative joint disease.VII.Oct. 16, 2000- Triglyceride, blood pressure, and cholesterol abnormally high; intervention to reduce began.Primary hypertension is of unknown etiology. The hemodynamic and pathophysiologic derangements are unlikely to result from a single cause. Heredity is a factor, but its exact effect is unknown. There are environmental factors such as stress, obesity, and dietary sodium that are related to hypertension. The pathogenic mechanisms lead to increased total peripheral vascular resistance by causing vasoconstriction, that thus increases cardiac output and blood pressure. Abnormal sodium transport across a cell wall due to a defect in or inhibition of the sodium-potassium pump or due to increased permeability of the sodium cation causes hypertension. As a result of increased cellular sodium cation, the sympathetic nervous system is more likely to be stimulated because of i...
