Peer Responses: Length: A minimum of 275 words per post, not including reference

Peer Responses:
Length: A minimum of 275 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
According to Smith et al. (2020), this patient’s blood pressure is not adequately controlled and far exceeds the 130 to 139/70 to 79 blood pressure that is recommended in this age group. The treatment threshold for a healthy patient in his age group is greater than or equal to 150/90, however, this value is lower in patients with chronic kidney disease and diabetes mellitus (Smith et al., 2020). The case study is missing information that is necessary for the provider to make an informed decision about the patient’s health including the dosage of the hydrochlorothiazide and metoprolol. The provider also does not know what medications have been tried in the past to ensure the provider does not attempt to prescribe the patient medication in a class that the patient has had an adverse reaction to. This patient likely should have already been tried on a calcium channel blocker prior to being prescribed a beta blocker based on the recommended progression of blood pressure treatment unless there is a history the provider does not know about such as heart failure or myocardial infarction (Smith et al., 2020). Assuming the patient does not have a contraindication to the medication, I would start the patient on amlodipine 5 mg once daily #30 refills 2 and have him follow up in a month. I would have the patient get bloodwork done during this time as I want to screen him for diabetes mellitus and chronic kidney disease as this would change the acceptable threshold for him to greater than or equal to 140/90 according to Smith et al. (2020).
This patient’s advanced age and hyperlipidemia puts him at high risk of atherosclerotic cardiovascular disease warranting the need for medication to decrease his risks (Hoover, 2019). According to Hoover (2019), the maximum tolerated statin therapy should be prescribed. Hoover (2019) recommends starting with a moderate-intensity statin. I would start with atorvastatin 20 mg once daily and recheck labs in 6 months.
References
Hoover, L. (2019). Cholesterol management: ACC/AHA updates guideline. American Academy of Family Physicians. https://www.aafp.org/pubs/afp/issues/2019/0501/p589.html
Smith, D., Lennon, R., & Carlsgaard, P. (2020). Managing hypertension using combination therapy. American Academy of Family Physicians. https://www.aafp.org/pubs/afp/issues/2020/0315/p341.html