Holistic Diagnosis of Grade 1 Hypertension in a Pre-Elderly Patient Through a Family Medicine Approach

Hypertension is a chronic non-communicable disease requiring comprehensive management beyond pharmacological therapy, particularly in the pre-elderly population aged 45–59 years who are at heightened risk of target organ damage. This study employed a case report design with a family medicine approach conducted at a Public Health Center in Central Jakarta, supplemented by a home visit. The subject was Mrs. H, a 52-year-old pre-elderly woman with a thirteen-year history of grade 1 hypertension (142/78 mmHg) receiving amlodipine 10 mg once daily, who had never participated in the chronic disease management program. A three-day food record revealed an average daily caloric intake of 3,131 kcal, far exceeding the requirement of 1,167 kcal, with a MET value of 1.64 indicating a sedentary pattern. Family APGAR scored 8 (highly functional), SCREEM identified education as the primary barrier, and religious perception scores were adequate for both patient (99) and family (19). House assessment scored 1,185, meeting healthy house criteria, though Clean and Healthy Living Behavior was categorized as poor (score 5). The absence of periodic laboratory screening raised significant concern for undetected target organ damage. Comprehensive management across patient-centered, family-focused, and community-oriented levels included DASH diet counselling (1,167 kcal/day), swimming with the husband as low-impact physical activity, medication adherence education, engagement of husband and child in dietary modification, smoking cessation counselling for the husband, referral for target organ damage assessment, and environmental hygiene promotion. This case demonstrates that a holistic family medicine approach effectively identifies multidimensional risk factors and clinical gaps in pre-elderly hypertensive patients, enabling more targeted interventions at the primary care level.