Question

A 62 year old man with hypertension remains uncontrolled (BP 160/95 mmHg) despite adherence to three antihypertensive agents of different classes at adequate doses, including a diuretic. Which of the following is the most appropriate next step in evaluation?

Accepted Answer

Evaluate for secondary causes such as renal artery stenosis, primary aldosteronism or obstructive sleep apnoea

Answer

Simply add a fourth antihypertensive without further assessment

Answer

Stop all antihypertensives for a period to observe natural blood pressure

Answer

Refer only to a psychologist for stress management

Answer

Switch all medications to beta blockers

Practice question

A 62 year old man with hypertension remains uncontrolled (BP 160/95 mmHg) despite adherence to three antihypertensive agents of different classes at adequate doses, including a diuretic. Which of the following is the most appropriate next step in evaluation?