Managing Chronic Hypertension in a 56-Year-Old Woman: Relief from Dizziness and Nausea through Medication and Lifestyle Adjustments
Hypertension, often referred to as the "silent killer," can lead to various complications if left untreated. In this case study, we examine a 56-year-old woman who presented with sudden episodes of dizziness and nausea, later diagnosed as symptoms of chronic hypertension. Through timely medical intervention and lifestyle modifications, her symptoms were effectively managed, and her blood pressure was stabilized.
Case Overview
Patient: Female, 56 years oldDiagnosis: Chronic HypertensionHospital: First Affiliated Hospital of Anhui Medical UniversityVisit Date: January 2022Treatment: Combination therapy with nifedipine extended-release tablets and perindopril tert-butylamine tabletsTreatment Duration: 7 days of inpatient care followed by 2 months of outpatient follow-upOutcome: Successful reduction of dizziness and nausea, with stable blood pressure levels
Initial Presentation
The patient arrived at the clinic accompanied by her husband. She was overweight and reported experiencing sudden dizziness upon standing up a week prior. Initially, the symptoms subsided after a few minutes of rest, so she did not seek immediate medical attention. However, the dizziness persisted and worsened, often accompanied by nausea and difficulty standing. A prior CT scan at a local hospital showed no abnormalities in the brain, but her blood pressure was found to be elevated. Upon examination, her blood pressure measured 162/82 mmHg. She was alert but appeared fatigued. Cardiac examination revealed an enlarged heart border, regular rhythm, and no pathological murmurs. Based on her medical history and physical findings, she was preliminarily diagnosed with chronic hypertension.
Diagnostic Process and Treatment Plan
To rule out stroke, further diagnostic tests were conducted. A brain MRI showed multiple ischemic lesions but no signs of infarction. Ambulatory blood pressure monitoring confirmed persistent hypertension, with average readings of 146/76 mmHg, higher than the normal threshold of less than 130/80 mmHg. Echocardiography revealed left ventricular hypertrophy, and lipid levels were elevated. Given these findings, a dual antihypertensive regimen was initiated using nifedipine extended-release tablets and perindopril tert-butylamine tablets. The goal was to maintain blood pressure below 130/80 mmHg to reduce the risk of further organ damage.
Positive Response to Treatment
On the first day of hospitalization, the patient began taking nifedipine, and her blood pressure dropped to 148/76 mmHg, with a noticeable improvement in dizziness. After completing additional tests on day two, perindopril was added to her treatment plan to enhance blood pressure control and help reverse cardiac remodeling. By the end of her 7-day hospital stay, her blood pressure had stabilized at approximately 132/78 mmHg. Her dizziness had significantly subsided, and she experienced no further episodes of nausea. She was discharged and continued to attend outpatient follow-ups for two months. During this time, her blood pressure remained within the target range, and she remained symptom-free.
Recommendations for Long-Term Management
The patient responded well to treatment, and her symptoms improved. However, due to her weight and sedentary lifestyle, she was advised to adopt long-term health strategies to maintain her cardiovascular health.
- Dietary Adjustments: Reduce intake of saturated fats and cholesterol, and increase consumption of fresh fruits and vegetables. Regular lipid profile monitoring is also recommended.
- Physical Activity: Engage in moderate-intensity exercise such as walking, swimming, or aerobics. Avoid excessive or prolonged strenuous activity.
- Weight Management: Obesity increases the risk of hypertension and heart strain. Maintaining a BMI below 24 kg/m² is essential.
- Medication Monitoring: Perindopril may cause a persistent dry cough in some patients. Any adverse effects should be reported promptly to adjust therapy if necessary.
Clinical Insights and Final Thoughts
Chronic hypertension is increasingly common, often presenting with subtle or no symptoms until complications arise. Obesity is a significant risk factor, as it places additional strain on the cardiovascular system, potentially leading to left ventricular hypertrophy and elevated blood pressure. In this case, the patient already showed signs of target organ damage, as evidenced by the thickened interventricular septum on echocardiography. This underscores the importance of early blood pressure monitoring and intervention in overweight individuals. Timely diagnosis and comprehensive management—combining medication with lifestyle changes—are crucial in preventing further complications and improving long-term outcomes.