QuestionSBA
QuestionChoice
This patient is currently taking the maximum dose of amlodipine and therefore you cannot increase the dose further. This patient therefore requires the addition of another agent to control their blood pressure. In this case, NICE guidelines suggest the addition of an ARB such as losartan.
10025041
b
Increase dose of amlodipine
QuestionChoice
Spironolactone is a potassium-sparing diuretic that can be used in management of hypertension through its effects on the renin-angiotensin-aldosterone system (RAAS). However, it is not used before a calcium channel blocker and an ACE inhibitor or ARB have been tried together.
10025042
c
Spironolactone
QuestionChoice
Lifestyle modifications always play a part in the management of hypertension. However, this patient has consistently high blood pressure despite taking amlodipine so lifestyle modifications alone would not be enough. This patient requires the addition of another treatment to control their blood pressure.
10025043
d
Advise lifestyle modifications
QuestionChoice
This patient requires a second-line treatment to control their blood pressure. As she is already taking a calcium channel blocker (amlodipine), she should be given an angiotensin receptor blocker (ARB). ARBs are the preferred choice over angiotensin-converting enzyme (ACE) inhibitors for patients of African-Caribbean origin.
10025040
a
Add in losartan
QuestionChoice
This patient's blood pressure has remained above 140/90 despite treatment with amlodipine. Therefore, she requires the addition of a second medication to control her blood pressure.
10025044
e
Continue with current regime
Concept
Chapter
2693
3701
Hypertension
Topic
134
Cardiology
17406
A 64-year-old female presents to the GP for a blood pressure review. She is currently taking amlodipine 10mg once a day. She is of African-Caribbean origin. Her blood pressure reading comes back as 151/96.

What is the most appropriate next step in management?
a