The Curious Case Of A Reluctant Hypertensive Patient: Solve The Clinical Mystery


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Rajesh is a 50-year-old man working as a clerk in a private office. He does not stay with family and is away due to practical concerns. He is often a busy person at the office but does his work in time to have a tension-free day.

He often goes for a regular health check-up nearby to his home as he is more health-conscious.

Upon his regular consultation with the clinic nearby, he was recording ranges of repeated levels of high BP, and the highest among the recording is 205/91 mmHg. The clinic doctor has assessed his record as follows:

  • Smokes 30 Cigarettes daily
  • Consumes 100 units of alcohol per week
  • BMI 23.5
  • A family history of CV disorder (brother)
  • Healthy appearance overall

There was a long discussion with the doctor about the assessment. Rajesh was reluctant to agree to the ambulatory blood pressure monitoring; he agreed to HBPM (Home Blood Pressure Monitoring) long discussion with the doctor, with the reluctant patient, and a general blood test. 

The blood tests revealed the following: 

  • HPBM Average reading – 180/95
  • Total cholesterol 7.2 mmol/L, HDL 1.4 mmol/L, non-HDL 5.8 mmol/L
  • Normal Liver function test
  • QRISK 2 value of 36.1

He met the doctor again after the test results were out. During the appointment, he agreed to reduce alcohol and cigarette consumption and decrease overall salt consumption.

person writing on paper at lap

During the consultation, the doctor suggested the following too:

  • Medication is not an option for the current situation
  • Showed the risks associated with the blood test values

Finally, Rajesh agreed to take up some medication after a bit of reluctance and convincing sessions by the doctor. 


Write the answers in the “Comments” below this post or email at to win surprises!

Q1. Can you assess the patient’s current condition?

Q2. What did the Clinician do to convince Rajesh?

The correct answers will be published inside April 2022 Issue of Genomeden Global

Created By: Ravi Teja Yeramilli


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