Interesting. Yesterday I had a consultation with a patient with difficult-to-manage high blood pressure e heart failure. Interestingly, his average ambulatory monitoring was 143/78mmhg. I was on 4 drugs and no one had added a diuretic to the regimen.

Everything was left with carvedilol and a combination tablet with valsartan, hydrochlorothiazide and amlodipine. Lifestyle changes and exercise. Starting again at minimal doses, I hope he reach the goal. I even hope I can get him off some of his four hypertension medications in the future, since the beta blocker can't be taken off due to heart failure, and neither can valsartan.

#DocChain