MEDizzy - A 72-year-old woman comes to see you to establish care,

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HYPERTENSION

A 72-year-old woman comes to see you to establish care, after her previous physician retired. Her medical history is significant for diet-controlled diabetes and a myocardial infarction. She is taking aspirin, simvastatin, and amlodipine. On examination, her blood pressure is 170/95 mm Hg. She has an S4 gallop and 1+ pretibial edema. What should be the target blood pressure in the long term for this patient?

ExplanationThe correct answer is C. This patient has stage 2 (moderate) hypertension and is in risk group C because of her history of myocardial infarction and diabetes (either one alone would suffice to put her in this risk group). As such, her target blood pressure is less than 130/85 mm Hg. Note that there is some evidence that lowering patients' diastolic blood pressure to less than 70 mm Hg is associated with increased mortality.