The nurse is preparing medications for a client with a history of hypertension who is post-op day 3 following hip replacement.

Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Atorvastatin 40 mg PO, and Warfarin 4 mg PO.

Vital signs: blood pressure 138/90, heart rate 52, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.

Today’s labs: sodium- 143 meq/L, potassium 4.6 mmol/L, Hemoglobin 11.1 gm/dL, white blood count 10.8, INR 2.2

Which medication will the nurse hold?

Choice A reason: This is correct because high lipid levels, such as cholesterol and triglycerides, are a risk factor for cardiovascular disease. HMG-CoA reductase inhibitors, also known as statins, lower the production of cholesterol in the liver and reduce the risk of heart attack and stroke.

Choice B reason: This is incorrect because blood glucose of 60 is not related to the need for an HMG-CoA reductase inhibitor. Blood glucose of 60 is below the normal range and may indicate hypoglycemia, which is a low blood sugar level. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and hunger.

Choice C reason: This is incorrect because platelets over 150,000 are not related to the need for an HMG-CoA reductase inhibitor. Platelets are blood cells that help with clotting and prevent bleeding. The normal range of platelets is 150,000 to 450,000 per microliter of blood. Platelets over 150,000 are within the normal range and do not indicate a problem.

Choice D reason: This is incorrect because low INR is not related to the need for an HMG-CoA reductase inhibitor. INR stands for international normalized ratio and is a measure of how long it takes the blood to clot. The normal range of INR is 0.8 to 1.2. Low INR means the blood clots faster than normal and may indicate a risk of thrombosis, which is a blood clot in a vein or artery.

Choice A reason: Age is a non-modifiable risk factor for hypertension because the risk of high blood pressure increases as we get older. This is due to changes in the heart and blood vessels, such as loss of elasticity and stiffening of the arteries, that affect the blood flow and pressure. ¹

Choice B reason: Genetics is a non-modifiable risk factor for hypertension because some people inherit genes that make them more likely to develop high blood pressure. For example, people of African and Black Caribbean descent have a higher risk of hypertension due to genetic variations that affect salt sensitivity and blood vessel function. ²

Choice C reason: Smoking is a modifiable risk factor for hypertension because it can be changed or avoided by quitting tobacco use. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries that narrows them and raises blood pressure. Smoking also lowers the level of good cholesterol (HDL) and raises the level of bad cholesterol (LDL) and triglycerides, which are fats in the blood that contribute to plaque formation. ³

Choice D reason: Obesity is a modifiable risk factor for hypertension because it can be changed or prevented by losing weight or maintaining a healthy weight. Obesity increases the risk of high blood pressure by putting extra strain on the heart and blood vessels, as well as by causing hormonal and metabolic changes that affect blood pressure regulation. Obesity is also associated with other conditions that can raise blood pressure, such as diabetes, sleep apnea, and kidney disease. ⁴

Choice E reason: Sedentary lifestyle is a modifiable risk factor for hypertension because it can be changed or improved by increasing physical activity. Sedentary lifestyle increases the risk of high blood pressure by reducing the ability of the blood vessels to dilate and contract, as well as by increasing the risk of obesity, diabetes, and high cholesterol. Physical activity helps to lower blood pressure by improving blood flow, strengthening the heart muscle, and lowering body weight and stress levels. .