Chapter 39 A 43-year-old man presents to the clinic you work at for a follow-up blood pressure check accompanied by his 9-year-old daughter. He is noted to still have hypertension (high blood pressure). The physician prescribes an angiotensin-converting enzyme (ACE) inhibitor. a. The 9-year-old daughter asks you how this medication works. How would you explain this to her in a way she can understand? b. What might be other suggestions (besides medications) you would make to this patient to help him decrease his blood pressure? Why?
a. Explaining how an angiotensin-converting enzyme (ACE) inhibitor works to a 9-year-old can be challenging, but it can be simplified in a way that she can understand. You can explain that our bodies have a natural system that helps control our blood pressure, and sometimes this system gets a little out of balance. High blood pressure means that the blood is pushing too hard against the walls of the blood vessels.
The ACE inhibitor medication works by blocking a specific enzyme in the body called ACE. This enzyme is part of the system that makes a hormone called angiotensin II. Angiotensin II can cause the blood vessels to become narrow, which makes it harder for the blood to flow. By taking the ACE inhibitor, the medication helps to block the ACE enzyme and reduce the production of angiotensin II. This, in turn, helps to relax the blood vessels and make it easier for the blood to flow.
b. In addition to medications, there are several other suggestions that can be made to help decrease blood pressure in this patient. Lifestyle modifications play a crucial role in managing hypertension. Here are a few suggestions:
1. Diet: Encourage the patient to follow a healthy and balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins. Limiting sodium intake is particularly important as excessive salt consumption can lead to high blood pressure.
2. Regular exercise: Engaging in regular physical activity, such as walking, biking, or swimming, can help lower blood pressure. It is recommended to aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity every week.
3. Weight management: If the patient is overweight or obese, losing even a small amount of weight can have a significant impact on blood pressure. Encourage the patient to work towards achieving and maintaining a healthy weight through a combination of healthy eating and increased physical activity.
4. Limit alcohol consumption: Drinking alcohol in moderation is advisable for individuals with hypertension. For men, this means limiting alcohol intake to no more than two drinks per day, and for women, no more than one drink per day.
5. Stress management: Chronic stress can contribute to high blood pressure. Encourage the patient to find healthy ways to manage stress, such as practicing relaxation techniques, engaging in hobbies, or seeking support from friends and family.
6. Smoking cessation: If the patient is a smoker, quitting smoking is essential to reduce the risk of cardiovascular diseases and lower blood pressure. Offer support and resources to help them quit smoking.
These suggestions are important for managing blood pressure because they address lifestyle factors that can contribute to hypertension. By adopting these changes, the patient can potentially reduce their blood pressure and improve their overall cardiovascular health. It is important to note that while lifestyle modifications can be effective in managing blood pressure, medications may still be necessary for some individuals, especially if lifestyle changes alone are not sufficient.
In conclusion, explaining how an ACE inhibitor works to a 9-year-old can be simplified by emphasizing how it helps to relax the blood vessels and improve blood flow. Additionally, suggesting lifestyle modifications such as a healthy diet, regular exercise, weight management, limiting alcohol consumption, stress management, and smoking cessation can all help to decrease blood pressure in this patient. Combining these lifestyle changes with medication, if necessary, can optimize blood pressure control and reduce the risk of complications associated with hypertension.