A 46-year-old man comes to the office for follow-up due to a blood pressure reading of 150/95 mm Hg during a preemployment examination. He has had no symptoms, and his medical history is unremarkable. The patient is an ex-smoker with a 10-pack-year history; he does not use alcohol or illicit drugs. He has a family history of hypertension, and his father died of a stroke at age 68. Blood pressure is 145/90 mm Hg (repeat: 144/92 mm Hg), and pulse is 75/min and regular. BMI is 29 kg/m2. Physical examination is unremarkable. This patient should be screened for which of the following conditions?
Question
A 46-year-old man comes to the office for follow-up due to a blood pressure reading of 150/95 mm Hg during a preemployment examination. He has had no symptoms, and his medical history is unremarkable. The patient is an ex-smoker with a 10-pack-year history; he does not use alcohol or illicit drugs. He has a family history of hypertension, and his father died of a stroke at age 68. Blood pressure is 145/90 mm Hg (repeat: 144/92 mm Hg), and pulse is 75/min and regular. BMI is 29 kg/m2. Physical examination is unremarkable. This patient should be screened for which of the following conditions?
Solution
This patient should be screened for diabetes. The patient's age, blood pressure, family history of hypertension, and BMI all suggest a risk for Type 2 diabetes. The American Diabetes Association recommends screening for Type 2 diabetes in adults of any age who are overweight or obese (BMI ≥25 kg/m2) and who have one or more additional risk factors for diabetes. In this patient, these risk factors include hypertension (blood pressure >140/90 mm Hg) and a family history of diabetes.
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