Question

harriet, a 79 - year - old woman, comes to your office every 3 months for follow up on her hypertension. her medications include one baby aspirin daily, lisinopril 5mg daily, and calcium 1500 mg daily. at todays visit, her blood pressure is 170/89. according to jnc viii guidelines, what should you do next to control harriets blood pressure? increase her lisinopril to 20mg daily add a thiazide diuretic to the lisinopril 5mg daily discontinue the lisinopril and start a combination of ace inhibitor and calcium channel blocker discontinue the lisinopril and start a diuretic

Explanation:

According to JNC VIII guidelines, for an elderly patient with hypertension not at goal (blood - pressure 170/89 mmHg on 5mg of Lisinopril), increasing the dose of the current ACE - inhibitor (Lisinopril) is a reasonable first - step. Adding a thiazide diuretic is also a common approach but increasing the Lisinopril dose is often tried first. Discontinuing Lisinopril and starting other combinations or diuretics alone is not the most immediate step.

Answer:

Increase her Lisinopril to 20mg daily