Such factors such as age and race are risk factors that are not able to be changed. Seeing that K. H is 67 years of age is an increasing risk factor, once the age of 60 is reached the greater the risk of hypertension as well as an increase in systolic pressure. The fact that K. H is an African American is another non-modifiable risk factor. The African American race is known to have a genetic related higher salt sensitivity. The risk factors that he can control are his weight and diabetes mellitus. The fact that K.
H is 30 pounds over his ideal weight, while not clearly stating if he is overweight it is implied. Being overweight can result in a two- to six fold increase of risk of hypertension. Since K. H is on a salt-restricted weight loss diet, he appears to be trying to lower that risk. While his diabetes mellitus doesn’t appear to be changed, most causes of diabetes mellitus are linked to the patient being overweight/obese. By being on a weight loss diet, K. H can lower his weight to decrease his risk of hypertension along with helping with his diabetes mellitus.
The rationale reason for treating K. H with an ACE inhibitor is easy. The purpose of an ACE inhibitor is that it blocks the conversion of angiotensin I to angiotensin II. ACE, or angiotensin converting enzyme allows for this conversion, which is why he is prescribed an ACE inhibitor. Angiotensin II narrows blood vessels and increases blood pressure, which can lead to hypertension. Patients who suffered from heart failure were found to have high amounts of angiotensin II in their system.
Angiotensin is also known for fluid retention within the body and vasoconstriction of the blood vessels, it also stimulates the adrenal glands to release aldosterone. Aldosterone allows for the reabsorption of sodium, exactly what K. H does not need, leads to an increased blood volume. By taking an ACE inhibitor the conversion is not going to be made, which allows for a decrease in the amount of angiotensin II in the system, leading to dilation of the blood vessels and a decrease in blood pressure.