Discussion
1
The first step to help the patient reduce his blood pressure would be to help him quit smoking. Since the patient is currently smoking two packs of cigarettes a day, he knows he is a very heavy smoker, which is taking a physical and economic toll. No doubt, he is aware of different available options that can facilitate quitting smoking—such as patches and gum—but I would recommend that he switch to vaping, which can deliver a throat hit that is comparable to the act of smoking a real cigarette as well as the nicotine high found in cigarettes. For a heavy smoker, vaping e-liquids with a nicotine content of at least 12 would be appropriate to help him quit his habit. Polosa, Caponnetto, Cibella and Le-Houezec (2015) have found that vaping e-juices can be an effective way to quit cigarettes.
The second step would be to exercise more by taking walks before or after lunch. His eating habits at restaurants should also be addressed for the third step: eating healthy, with salads and fresh, organic foods instead of fried or high-cholesterol foods would be very helpful.
2
The top three risk factors for this patient are: 1) heavy smoking, 2) poor diet, and 3) obesity as measured by BMI and waist-hip ratio. The patient must stop smoking immediately, must begin eating a healthy diet, and must begin exercising regularly, even if it is just walking. Diet and exercise will be very helpful in allowing the patient to lose weight and reduce the risk of hypertension (Soltani, Shirani, Chitsazi and Salehi-Abargouei, 2016). Using a vape pen to help the patient quit smoking will also be facilitative of this overall design.
References
Polosa, R., Caponnetto, P., Cibella, F., & Le-Houezec, J. (2015). Quit and smoking
reduction rates in vape shop consumers: a prospective 12-month survey. International Journal of Environmental Research and Public Health, 12(4), 3428-3438.
Soltani, S., Shirani, F., Chitsazi, M. J., & Salehi?Abargouei, A. (2016). The effect of
dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta?analysis of randomized controlled clinical trials. Obesity Reviews, 17(5), 442-454.
