Week 1 Assignment 3: Mini Case Study

A 35-year-old male has been diagnosed with hypertension. It is worth noting that cardiovascular diseases remain the primary cause of mortality in the developed world, and hypertension creates a fruitful basis for the development of other health complications. Meanwhile, the physician makes a decision to place the man with hypertension on an ACE inhibitor. According to Brown and Vaughan (1998), captopril is the only ACE inhibitor that is available to patients in generic form. Yet, regardless of the type of the ACE inhibitor used by the patient, the importance of quality patient education should not be ignored. The patient has a positive family history of Type 2 Diabetes as well as heart disease. The patient must be aware of what awaits him in terms of using the ACE inhibitor and how his health state can and should be monitored.

To start with, ACE inhibitors are used by millions of patients around the globe, and their safety is proven and widely documented. According to Sweitzer (2003), ACE inhibitors should be taken by those, who have undergone heart failure, have coronary heart disease, as well as high blood pressure and the so-called “diabetic tendency.” As such, it is possible to say that the benefits of using the ACE inhibitor by the patient are two-fold. On the one hand, ACE inhibitors successfully relax constricted blood vessels, reducing blood pressure in individuals with hypertension (Sweitzer, 2003). On the other hand, the patient must know that the drug also reduces the risks of diabetes and diabetes complications, if diabetes actually develops. The use of ACE inhibitors to reduce the risks of diabetic neuropathy is of particular benefit (Gulledge & Beard, 1999). The drug also decreases proteinuria, regardless of the type of diabetes the patient actually develops and the duration of the therapy (Gulledge & Beard, 1999). In other words, it is worth informing the patient that the use of the ACE inhibitor is the best option he can have, given his diagnosis and family history.

However, the patient should know what awaits him in terms of using the ACE inhibitor. Despite the high levels of safety, ACE inhibitors are drugs with adverse effects. Basically, the patient should avoid using high doses of the drug at the beginning of the therapy. Bearing in mind that it lowers blood pressure, dizziness and lightheadedness may become a problem (Sweitzer, 2003). Furthermore, Sweitzer (2003) reports cough being one of the chief side effects of ACE inhibitors. However, the patient must know that only 8 percent of those who take ACE inhibitors develop a cough serious enough to discontinue the therapy (Sweitzer, 2003). Finally, the risks of negative effects on the patient’s kidney function should not be ignored. The patients, who already have renal insufficiency are particularly susceptible to these risks (Gulledge & Beard, 1999). The use of ACE inhibitors can further aggravate the situation. However, since no such conditions are reported in this case, one may expect that the use of the ACE inhibitor by the patient will improve his current health.

Unfortunately, as Mathieson, Severn and Guthrie (2013) report, the quality of monitoring in relation to ACE inhibitors prescription and use is far from the desired level. Still, despite the poor quality of ACE inhibitor monitoring, regular measurements of electrolytes and urea need to be performed to avoid renal complications (Mathieson et al, 2013). Although less than 2 percent of patients experience a renal event as a result of ACE inhibitor use, the risks of renal complications should be closely monitored (Mathieson et al, 2013). Blood sugar and blood pressure must be measured regularly to ensure that the ACE inhibitor benefits the patient without causing any adverse impacts on health.

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