What kind of antihypertensive medicine would you choose

Since the administration of two kinds of antihypertensive agents (ACE inhibitor and calcium channel blocker) are not enough for controlling BP of the patient, the addition of a thiazide diuretic could be a good choice (thiazides have a synergistic action with ACE inhibitors and there are fix combinations in the market). The primary target is to achieve BP levels < 130/80 mmHg, necessarily using a medicine blocking the renin-angiotensin axis. Monitoring of the patient's BP and repeat of urine protein measurement will show if this target can be achieved in the next 3-6 months. If not, treatment should be intensified with the addition of a fourth antihypertensive medicine (ARB or other category; see Table 22.1 in Chapter 22 for a list of categories of antihypertensive medicines).

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