QuestionSBA
QuestionChoice
This patient is currently taking the maximum dose of Amlodipine (10mg) and therefore you cannot increase the dose further. He therefore requires the addition of a second agent to control their blood pressure; in this case, losartan.
10007707
c
Increase dose of Amlodipine
QuestionChoice
Spironolactone is used as a 4th step in hypertension management, where serum potassium is below 4.5mmol/l. The patient in this question is taking amlodipine only, therefore requires a second agent to control blood pressure. In this case, the best second step is losartan.
10007708
d
Add Spironolactone
QuestionChoice
This patient requires an additional treatment as their blood pressure is not controlled (i.e under 140/90 in clinic) with amlodipine alone. Patients of African-Caribbean origin already taking a calcium channel blocker, who require a second agent, should be given an angiotensin receptor blocker rather than an ACE inhibitor. Therefore, losartan should be given to this patient.
10007706
b
Add Ramipril
QuestionChoice
A beta blocker like bisoprolol is used as a 4th step treatment in hypertension. It is used if potassium is over 4.5mmol/l. The patient in this question is taking amlodipine only, therefore requires a second agent to control blood pressure. In this case, the best second step is losartan.
10007709
e
Add Bisoprolol
QuestionChoice
This patient requires an additional treatment as their blood pressure is not controlled (i.e under 140/90 in clinic) with amlodipine alone. Patients of African-Caribbean origin already taking a calcium channel blocker, who require a second agent, should be given an angiotensin receptor blocker rather than an ACE inhibitor. Therefore, losartan should be given to this patient.
10007705
a
Add Losartan
QuestionComment
I think the latest guideline reveals CCB + ACEi or ARB or thiazide if CCB doesn't work.
27002
User
subscriber
Bladder Kinin
Concept
Chapter
2693
3701
Hypertension
Topic
134
Cardiology
14088
A 66-year-old male attends the GP for a blood pressure review. He is of African-Caribbean origin and is currently taking amlodipine (10mg). His blood pressure reading comes back as 144/95.

Which of the following is the most appropriate next step?
a