Primary care - Hypertension, BP, Review

Hypertension Review Note Consult Summary: 55-year-old male with uncontrolled HTN, non-compliant with medication, reports dizziness and headaches. Subjective: Patient presents for hypertension review due to elevated BP readings at home. Reports non-adherence to medication regimen due to side effects of dizziness. Past medical history includes type 2 diabetes and hyperlipidemia. Current medications include Lisinopril 20 mg daily, Metformin 500 mg BID, and Atorvastatin 10 mg daily. Social history reveals smoking 10 cigarettes/day, alcohol intake of 5 units/week, sedentary lifestyle, and high-stress job. No known drug allergies. Review of Systems: Cardiovascular symptoms include occasional CP and DOE. Neurological symptoms include frequent dizziness and headaches. Renal symptoms include nocturia. Review of Systems summary: CP, DOE, dizziness, headaches, and nocturia noted. Objective: BP: 160/100 mmHg HR: 88 bpm BMI: 29.1 (Weight: 85 kg, Height: 1.72 m) Recent Labs: Lipids: Total cholesterol 5.8 mmol/L, LDL 3.2 mmol/L, HDL 1.0 mmol/L, Triglycerides 2.1 mmol/L HbA1c: 7.2 % Renal Function: eGFR 85 mL/min, Creatinine 90 µmol/L Assessment & Plan: Hypertension: Uncontrolled. Investigations ordered: 24-hour ambulatory BP monitoring. Medication adjustments: Increase Lisinopril to 40 mg daily. Lifestyle advice given: Smoking cessation, reduce alcohol intake, adopt a low-sodium diet, and increase physical activity. Referrals: Dietitian for dietary management. Follow-up plan: Review in 4 weeks with BP diary. \bp 160/100 \Wt 85 \Ht 172