History includes osteopenia and anxiety

Reference no: EM133722530

Question

A 78-year-old woman comes to the office to establish care. She feels well. She is semi-retired and walks 1-2 miles daily. History includes osteopenia and anxiety. Current medications are alendronate 70 mg once each week and daily multivitamins. She stopped smoking cigarettes 30 years ago. She has no chest pain, dyspnea, or palpitations. She recently bought a home blood pressure monitor; in the past week, seated blood pressures were 125/80 mmHg, 130/75 mmHg, and 135/73 mmHg. On examination, BMI is 25 kg/m2. Seated blood pressure is 155/80 mmHg and heart rate is 88 beats per minute; standing blood pressure is 145/75 mmHg and heart rate is 92 beats per minute. She appears to be mildly anxious, with no tremor or sweating. Thyroid is not enlarged. All other findings are normal. CBC, complete metabolic panel, and thyrotropin levels are normal. High-density lipoprotein cholesterol is 60 mg/dL; low-density lipoprotein cholesterol is 130 mg/dL. Electrocardiography is normal, except for sinus tachycardia with heart rate of 102 beats per minute. What is the most appropriate recommendation for this patient?

Reference no: EM133722530

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