07-09-2006, 11:37 AM
A 49-year-old man with diabetes mellitus comes to the office for a follow-up visit. He also has a 12-year
history of high blood pressure that has been treated well with hydrochlorothiazide and atenolol. You
notice that on his most recent set of laboratory results that his fasting blood glucose is 268 mg/dl and
his HA1C is 7.2%. He quit smoking two years ago but continues to have one to two beers per day. His
blood pressure is 135/75 mm Hg in his right arm and 130/80 mm Hg in his left arm, both sitting. His
physical examination is unremarkable. The most appropriate intervention at this time is to
A. add enalapril to his existing regimen
B. discontinue his diuretic and add enalapril
C. increase his dose of atenolol
D. increase his dose of hydrochlorothiazide
E. make no changes to his medications as the patient has excellent blood pressure control
history of high blood pressure that has been treated well with hydrochlorothiazide and atenolol. You
notice that on his most recent set of laboratory results that his fasting blood glucose is 268 mg/dl and
his HA1C is 7.2%. He quit smoking two years ago but continues to have one to two beers per day. His
blood pressure is 135/75 mm Hg in his right arm and 130/80 mm Hg in his left arm, both sitting. His
physical examination is unremarkable. The most appropriate intervention at this time is to
A. add enalapril to his existing regimen
B. discontinue his diuretic and add enalapril
C. increase his dose of atenolol
D. increase his dose of hydrochlorothiazide
E. make no changes to his medications as the patient has excellent blood pressure control