Case study for pathophysiology

The wife can use an automated bicep or wrist cuff, she doesn't need the scope. This is a somewhat outdated scenario.

"What risk factors for primary hypertension are evident from K.H.’s history and physical data?" -- Mr. K.H.'s most evident risk factors for primary HTN are his age, his race, the extra 30 lbs. and his DM. I have no idea if his sodium intake is high (no information about Na levels) so I don't know if sodium restriction is appropriate.

"What is the rationale for treating K.H. with an ACE inhibitor?" -- When medications are prescribed, ethnicity needs to be taken into consideration. Some meds work better for some ethnic groups than for others. (If his ACE inhibitor is lisinopril, he should be watchful for the ACE inhibitor cough)

" What is the mechanism of action?" -- Angiotensin II is a vasoconstrictor. Vasoconstriction elevates B/P. Angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme or ACE. ACE inhibitors interfere with the activity of the enzyme ACE and this decreases the production of angiotensin II. As a result, you have vasodilation and blood pressure is reduced.

"for the first question I see that he is at risk for primary hypertention because his weight, blood pressure, and high heart rate. Is that it?" -- I don't see what you see. The weight is a contributory factor but it's only 30 lbs, so it's not that significant and wouldn't matter at all if K.H. were metabolically healthy, however you should inlcude it as a risk factor. His blood pressure is split. The SBP is prehypertensive (probably thanks to the ACE inihibitor) and the DBP is hypertensive, so the whole thing is hypertensive. Without the ACE, it would be higher. But BP isn't a risk factor. It's the result of risk factors. Did you learn what the normal ranges for V/S are? 70 is perfectly normal.