--- name: hypertension description: Hypertension management - blood pressure monitoring, target organ damage assessment, cardiovascular risk evaluation, and medication tracking argument-hint: allowed-tools: Read, Write schema: hypertension/schema.json --- # Hypertension Management Skill Comprehensive blood pressure monitoring and management to help control blood pressure and reduce cardiovascular risk. ## Core Flow ``` User Input -> Identify Operation Type -> Extract Parameter Info -> Check Completeness -> [Need Supplement] Ask User | [Information Complete] | Generate JSON -> Save Data -> Output Confirmation ``` ## Step 1: Parse User Input ### Operation Type Recognition | Input Keywords | Operation Type | Description | |----------------|----------------|-------------| | record, bp, blood pressure | bp_record | Log blood pressure | | trend | trend_analysis | View blood pressure trend | | average | average_calculation | Calculate average BP | | history | history_view | View history records | | status | status_view | View achievement status | | risk | risk_assessment | Cardiovascular risk assessment | | target | target_view | View BP targets | | heart | heart_assessment | Heart assessment record | | kidney | kidney_assessment | Kidney assessment record | | retina | retina_assessment | Retina assessment record | | medication | medication_management | Medication management | ### Blood Pressure Value Parsing Recognize format: `XXX/YY` or `XXX YY` - Systolic: First value - Diastolic: Second value ### Measurement Time Keywords | Input Keywords | Time Value | |----------------|------------| | morning | morning | | evening | evening | | noon | noon | | night | night | ### Measurement Position Keywords | Input Keywords | Position Value | |----------------|----------------| | sitting | sitting | | standing | standing | | lying | lying | ### Measurement Arm Keywords | Input Keywords | Arm Value | |----------------|-----------| | left | left | | right | right | ### Target Organ Assessment Keywords #### Heart Assessment | Input Keywords | Exam Type | |----------------|-----------| | echo | echocardiogram | | ecg | ecg | | lvh | left_ventricular_hypertrophy | #### Kidney Assessment | Input Keywords | Indicator | |----------------|-----------| | uacr | uacr | | egfr | egfr | | creatinine | creatinine | #### Retina Assessment | Input Keywords | Grade | |----------------|-------| | grade-0 | grade_0 | | grade-1 | grade_1 | | grade-2 | grade_2 | | grade-3 | grade_3 | | grade-4 | grade_4 | ## Step 2: Check Information Completeness ### BP Record Required: - Systolic (mmHg) - Diastolic (mmHg) ### Target Organ Assessment Required: - Assessment type - Assessment result ### Cardiovascular Risk Assessment Needs: - Age - Gender - Systolic BP - Smoking status - Diabetes status - Total cholesterol - HDL cholesterol - Antihypertensive treatment status ## Step 3: Interactive Prompts (If Needed) ### Scenario A: Incomplete BP Values ``` Please provide complete BP reading, format: systolic/diastolic Example: 135/85 ``` ### Scenario B: Additional Information Inquiry ``` Please supplement the following information (optional): - Heart rate (pulse XX) - Measurement time (morning/evening) - Measurement position (sitting/standing/lying) - Measurement arm (left/right) ``` ### Scenario C: Missing Target Organ Assessment Parameters ``` Please provide assessment results: - Echocardiogram: normal/abnormal/lvh - ECG: normal/abnormal - Urine microalbumin (UACR): value (mg/g) - eGFR: value (ml/min/1.73m²) - Retina grade: grade_0-4 ``` ## Step 4: Generate JSON ### Blood Pressure Record ```json { "id": "bp_20250102080000001", "date": "2025-01-02", "time": "08:00", "systolic": 135, "diastolic": 85, "pulse": 78, "position": "sitting", "measurement_device": "home_monitor", "arm": "left", "classification": "High-normal", "in_target": false } ``` ### Target Organ Damage Assessment ```json { "left_ventricular_hypertrophy": { "status": "none", "last_assessment": "2025-01-15", "method": "echocardiogram" }, "microalbuminuria": { "status": "negative", "uacr": 15, "reference": "<30", "date": "2025-06-10" }, "retinopathy": { "grade": "grade_0", "last_exam": "2025-03-20" }, "arterial_stiffness": { "pwv": 7.5, "reference": "<10", "date": "2025-02-15" } } ``` ### Cardiovascular Risk Assessment ```json { "assessment_date": "2025-06-20", "ascvd_risk_score": 12.5, "risk_level": "High", "risk_factors": [ "Hypertension", "Age >55", "Elevated total cholesterol" ], "recommendations": [ "Strict BP control", "Statin therapy", "Lifestyle intervention" ] } ``` Complete schema definition: see [schema.json](schema.json). ## Step 5: Save Data 1. Read `data/hypertension-tracker.json` 2. Update corresponding sections based on operation type 3. Update statistics 4. Write back to file ## Execution Instructions ``` 1. Identify operation type (record/trend/average/history/status/risk/target/heart/kidney/retina/medication) 2. Extract parameter information 3. Check required field completeness 4. If missing, ask user to supplement 5. Generate JSON compliant with schema.json 6. Save to data/hypertension-tracker.json 7. Output confirmation and medical recommendations ``` ## Example Interactions ### Example 1: Record Blood Pressure ``` User: record 135/85 pulse 78 AI: Blood pressure measurement recorded Time: 2025-01-02 08:00 Systolic: 135 mmHg Diastolic: 85 mmHg Pulse: 78 bpm Classification: High-normal Target: <130/80 mmHg Status: Not on target (elevated systolic) Recommendation: Reduce sodium intake, exercise regularly, monitor regularly ``` ### Example 2: View Blood Pressure Trend ``` User: trend AI: Blood pressure trend analysis (past 7 days) ━━━━━━━━━━━━━━━━━━━━━━━━━━ Average BP: 132/83 mmHg Morning average: 135/85 mmHg Evening average: 128/80 mmHg Circadian rhythm: Dipper (normal) Achievement rate: 71.4% Trend: BP control stable, morning BP slightly elevated Recommendation: Continue monitoring, pay attention to morning BP control ``` ### Example 3: Cardiovascular Risk Assessment ``` User: risk AI: Cardiovascular Risk Assessment ━━━━━━━━━━━━━━━━━━━━━━━━━━ 10-year ASCVD risk: 12.5% Risk level: High Major risk factors: - Hypertension (currently poorly controlled) - Age >55 - Elevated total cholesterol Recommendations: 1. Strict BP control to target 2. Consider statin therapy 3. Low-salt diet, regular exercise 4. Quit smoking, limit alcohol Recommendation: Seek medical attention soon, consult doctor for treatment adjustment ``` ### Example 4: View Achievement Status ``` User: status AI: Blood Pressure Achievement Report ━━━━━━━━━━━━━━━━━━━━━━━━━━ BP Target: <130/80 mmHg Past 7 days: - Average BP: 132/83 mmHg - Days on target: 5/7 (71.4%) - Achievement rate: 71.4% Past 30 days: - Average BP: 128/81 mmHg - Days on target: 22/30 (73.3%) - Achievement rate: 73.3% Control Evaluation: BP control approaching target, keep working ``` For more examples, see [examples.md](examples.md). ## Medical Safety Boundaries ### Cannot Do: - Provide specific medication dosage adjustment recommendations - Directly prescribe or recommend specific medications - Replace doctor's diagnosis and treatment decisions - Predict disease prognosis or complication occurrence ### Can Do: - Provide blood pressure monitoring records and trend analysis - Provide target organ damage assessment records - Provide cardiovascular risk calculation (for reference only) - Provide lifestyle recommendations and medical visit reminders ### Emergency Medical Indications: - Systolic >=180 mmHg AND diastolic >=120 mmHg - Accompanied by chest pain, difficulty breathing, speech difficulty - Headache, confusion, vision changes - Facial or limb numbness/weakness