Reference no: EM133758163

Question

Mr. Michaels is a 65-year-old male with high blood pressure who comes in for a recheck. His previous doctor retired. He has been on BP meds for years [prescribed by his previous provider and his son in law, who is a nephrologist]. He says he feels well, but his BP has been running high. He shows you his BP log-systolic 160s-170 and diastolic 88-98. He denies CP, SOB or edema. He still works part time in the technology company that he founded 25 years ago. He does not smoke or drink. He has no allergies. Past Medical History-CAD [stent in right coronary at the age of 40]; Proteinuria; HTN; Dyslipidemia, Obstructive Sleep Apnea [on CPAP], paroxysmal atrial fibrillation Current Medications-Hydralazine 50 mg BID; HCTZ 25 mg each AM; Crestor 40 mg each evening; ASA 81 mg [he says he only takes it on the days that the top number on his BP is less than 160 mm Hg]. On exam today, you see a 65 y/o Caucasian male who is 6'3" 300 pounds VS: 98-60-18 164/94 CBC, CMP normal; TSH normal; Urine analysis normal except 2 proteinuria EKG is normal today BS 110 mg/dL; creatinine 1.0 mg/dL