What Would You Do For This Diabetic With These ABPM Results?
A 76 years old man, type 2 diabetic for 10 years, on 1.0 gram of Metformin, HBA1C of 8%, BMI of 28.5, No Microalbuminuria, small right carotid intima thickness but no plaques. He has a healthy Life Style with regular exercises and Diet, taking also 10 mg Atorvastatin, and on Amlodipine 5 mg/day had a 24 hour Arterial Blood Pressure Monitoring requested by his GP because of his Hypertension. These are the Main Results Report: - Mean 24 hours Systolic BP: 144 mmHg. - Mean 24 hours Diastolic BP : 84 mmHg. - Mean Systolic Daytime BP: 146 mmHg. - Mean Night time Systolic BP 142 mmHg. - Mean Daytime Diastolic BP: 86 mmHg - Mean Nigh time Diastolic BP: 82 mmHg. - Reduction of Night Time Dipper of Systolic and Diastolic BPs. Normal value, a Night BP reduction: beteween 10 to 20%. So he is considered as a "Non-Dipper" patient. What Would you Do?