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A 55-year-old Hispanic male patient presents to the clinic with a PMH of hypertension and type 2 diabetes mellitus. He is a non-smoker who works about 50 hours per week as a mid-level corporate manager. Thus far, he has been managed on hydrochlorothiazide (HCTZ) for his HTN and metformin for his T2DM. He has been exercising regularly and working to control his diet. His home blood glucose logs show that he has been making improvements in his fasting blood glucose. His home blood pressure logs show readings between 150-160/90-100. In the clinic today his blood pressure was 155/96 mmHg. Post your responses to the following questions in this forum: Describe the mechanism of action of HCTZ? Was HCTZ an appropriate first line blood pressure agent in this patient? Why or why not? What should be this patient's blood pressure goal with his current disease states? To help bring the patient's blood pressure into goal range, name an agent that should be started in the patient. Describe the mechanism of action for your selected agent. Additional lab work came back the next week on the patient, showing he has a cholesterol profile of: TC: 230 mg/dL HDL: 25 mg/dL TG: 175.
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