How would you mange this patients Hypertension?

Thank you for asking, I’ve been practicing this answer

In 4 easy steps,

1) Non-pharmacologically

Stress Relief

Diet – low salt, low alcohol, weight reduction, if necessary, low fat

Regular aerobic exercise

Control other risk factors e.g. stop smoking

2) Pharmacologically

ACE-Inh e.g. lisinopril 5-20mg

B-Blocker e.g. metoprolol 25mg po bd to 100mg po bd

Carvedilol 3.125mg po bd to 25 mg po bd

CA-Channel Blocker e.g. Amlodipine 2.5mg to 10mg po daily

Diltiazem 180mg SR to 360mg SR daily

Diurectics e.g. Hydrochlorothiazide 12.5mg to 50mg po daily

3) Maintenance e.g. regular LMO visits, home monitoring

4) Ensure Compliance e.g. engage family members

If you are introducing a 2^nd or 3^rd agent, consider secondary causes

Renal- RAS, CRF

Endocrine – Hypothyroidism, Acromegaly, Cushings

Drugs e.g. alcohol

Coartation of Aorta

Autoimmune e.g. scleroderma, Nephritic Syndroome

Toxaemia of Pregnancy