L.D. 58 year old presents at the clinic concerning occasional chest pain.

The pain is received within minutes after he stops walking. He has been
diagnosed with DM type 2, dyslipidemia.
His most recent laboratory results are significant for the following:
BUN
Creatinine
Glucose
Hemoglobin A1C
Uric Acid
LDL
HDL
TG

15 mg/dl
1.0 mg/dl
150 mg/dl
10%
6.5 mg/dl
188 mg/dl
32 mg/dl
350 mg/dl

ECG apparently normal except for LVH.

ANGINA PECTORIS
LEARNING OBJECTIVES:
1. Identify the type of hypertension presented in the case as to JNC 8
Classification.
ANSWER: The type of hypertension L.D., our patient in this case is
primary hypertension.
Hypertension can be classified into two: primary or essential
hypertension and secondary hypertension.
Patients with high blood
pressure but with no known cause are said to have primary or essential
hypertension, while patients who have a specific cause of their high blood
pressure is classified as secondary hypertension. Causes of secondary
hypertension based on the JNC-8 guidelines would include disease states
such as kidney disease, adrenal gland tumors, thyroid disease, congenital
blood vessel disorders, alcohol abuse and obstructive sleep apnea. Drugs
and other products could also induce secondary hypertension like NSAIDs,
birth control pills, decongestants, cocaine, amphetamines, corticosteroids,
foods high in sodium and alcohol.
The type of hypertension L.D., our patient from the given case above,
could be primary hypertension because aside from significant levels of
high triglyceride and LDL values which would indicate dyslipidemia, BUN
and creatinine, which are indicators of renal function fall on the normal
values. Secondary hypertension comes into consideration if disorders of
the kidney and renal disease are present. (Harrisons, 19 th edition)