CASE FIVE Mr B.

F 55 year old hotel owner Stressed Attended for annual review No other PMH Not taking medication Smoker - 20 cpd Alcohol - bottle wine most nights BP 152/94

Is this hypertension?

Is he at risk?

What treatment should he receive?

CASE FIVE further information Mr B.F BP consistently > 150 systolic ACR 8 LVH on ECG eGFR 58 Chol 5.2 Started on ramipril 2.5 mg bd BP now 146/88

Was treatment (and choice) justified?

Treatment justified mild hypertension but end organ damage Standard for age would be C or D but has compelling indication for ACE I / ARB

What is his BP target?

130 / 80 mmHg

What treatment should he receive next?

Full dose ACE I and CCB??

CASE FIVE further information (2) Mr B.F Commenced on ramipril 5 mg BD, bendrofluazide 2.5 mg and amlodipine 10 mg od ACR 4 eGFR 56 Chol 5.1 BP now 134/84

Does he need more treatment?

What are your options?

What are the pro and cons of these options?