MKSAP: 51-year-old man with newly diagnosed hypertension and diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 51-year-old man is evaluated during a follow-up visit for management of newly diagnosed hypertension and diabetes mellitus. He has started a program of lifestyle modification for his diabetes but has not yet started antihypertensive therapy. He is currently taking no medications. On physical examination, blood pressure is 148/92 mm Hg, and pulse rate is 76/min. BMI is 33. The remainder of the examination is unremarkable. Laboratory studies show a serum creatinine level of 1.5 mg/dL (132.6 µmol/L) (estimated glomerular filtration rate of 52 mL/min/1.73 m2) and a serum potassium level of 4.2 mEq/L (4.2 mmol/L); a urine dipstick demonstrates no hematuria or proteinuria, and a spot urine protein-creatinine ratio is 50 mg/g. Which of the following is the most appropriate antihypertensive treatment for this patient? A. Hydrochlorothiazide B. Lisinopril C. Lisinopril and amlodipine D. Lisinopril and hydrochlorothiazide E. Lisinopril and losartan Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Diabetes Heart Source Type: blogs