Holistic Cardiovascular Risk Assessment and Family-Centered Management of Hypertension and Hyperlipidemia: A Case Report

Abstract

Hypertension and hyperlipidemia are major modifiable risk factors for cardiovascular disease, particularly when accompanied by obesity, unhealthy dietary habits, and insufficient physical activity. Effective management requires an integrated approach that addresses clinical conditions, behavioral factors, and family support. This case report describes the application of holistic cardiovascular risk assessment and family-centered management in a patient with long-standing hypertension and hyperlipidemia in a primary healthcare setting. A 50-year-old female with hypertension diagnosed at the age of 39 and a history of hyperlipidemia underwent a comprehensive family medicine assessment at Ardhito Medika Clinic, Bandar Lampung, Indonesia, on June 5, 2026. Clinical examination revealed a blood pressure of 125/80 mmHg, heart rate of 80 beats/min, respiratory rate of 18 breaths/min, and body temperature of 36.6°C. Anthropometric measurements showed a weight of 69 kg and height of 158 cm, corresponding to a body mass index of 27.6 kg/m². Laboratory findings indicated a total cholesterol concentration of 365 mg/dL. The patient reported regular use of amlodipine 10 mg, candesartan 8 mg, and simvastatin 5 mg. Identified cardiovascular risk factors included a family history of hypertension, frequent consumption of high-salt and high-fat foods, and insufficient physical activity. Family assessment using the Family APGAR instrument yielded a score of 10, indicating highly functional perceived family relationships, while the SCREEM assessment suggested generally supportive family resources. A family-centered intervention was provided through individualized education and behavioral counseling based on the 5A and 5R frameworks. Counseling focused on dietary sodium and fat reduction, increased physical activity, medication adherence, weight management, and regular cardiovascular risk monitoring. Family members were involved in supporting healthier household dietary practices and reinforcing recommended lifestyle modifications. The recorded blood pressure was within a controlled range at the documented assessment, despite the presence of multiple cardiovascular risk factors and markedly elevated total cholesterol. The patient reported regular medication use and demonstrated favorable perceived family functioning. However, serial blood pressure measurements, follow-up lipid profiles, and standardized pre- and post-intervention behavioral assessments were not available to establish the effectiveness of the counseling intervention. This case highlights the value of holistic cardiovascular risk assessment and family-centered counseling in identifying modifiable risk factors among patients with hypertension and hyperlipidemia. Integrating clinical evaluation, family functioning assessment, and individualized lifestyle counseling may support comprehensive primary healthcare management. Nevertheless, structured follow-up and objective clinical measurements are necessary to evaluate sustained cardiovascular risk reduction and intervention outcomes.