A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?

Exposure to cold temperatures should be avoided by the patient with peripheral vascular disease such as Raynaud’s disease.

This is because cold temperatures can trigger vasospasm, which is a sudden narrowing of the small arteries in the fingers or toes, limiting blood flow and causing pain, numbness and color changes.

Choice A is wrong because wearing warm mitten gloves can help prevent or reduce the severity of Raynaud’s attacks by keeping the hands warm.

Choice B is wrong because wearing socks can also help protect the feet from cold exposure and prevent or reduce Raynaud’s attacks.

Choice D is wrong because engaging in regular exercise can improve blood circulation and reduce the frequency and duration of Raynaud’s attacks.However, exercise should be done with caution and proper clothing to avoid injury or frostbite to the affected areas.

Normal ranges for peripheral vascular disease are not applicable, as it is a condition that affects the blood vessels and not a specific blood test or measurement.

However, some tests that can help diagnose peripheral vascular disease or its underlying causes are blood pressure measurement, ankle-brachial index, Doppler ultrasound, angiography, blood tests for cholesterol, glucose, clotting factors and inflammatory markers.

ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. They work by blocking the production of a hormone called angiotensin II, which narrows the blood vessels and increases blood pressure.By preventing this hormone from acting, ACE inhibitors lower blood pressure and reduce the workload on the heart. One of the most common side effects of ACE inhibitors is a dry cough, which occurs in 12–19% of people who take them. The cough is caused by the accumulation of a substance called bradykinin, which is normally broken down by angiotensin-converting enzyme (ACE).When ACE is inhibited, bradykinin levels increase and cause irritation and inflammation in the airways.

Choice A is wrong because decreased white blood cells are not a common side effect of ACE inhibitors.

However, some people may develop a condition called neutropenia, which is a low level of a type of white blood cell called neutrophils.This can increase the risk of infections and may require stopping the medication.

Choice B is wrong because swelling of the face and lips is not a common side effect of ACE inhibitors.

However, some people may develop a rare but serious allergic reaction called angioedema, which is a swelling of the deeper layers of the skin and mucous membranes.

This can affect the face, lips, tongue, throat, or other parts of the body and can cause difficulty breathing or swallowing.Angioedema can be life-threatening and requires immediate medical attention.

Choice D is wrong because renal failure is not a common side effect of ACE inhibitors.

However, some people may experience a decrease in kidney function or an increase in blood levels of creatinine, which is a waste product filtered by the kidneys.