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Hypertension step-up therapy — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsHypertension step-up therapyGPhC CRA

A 55-year-old man has been taking amlodipine 5 mg daily for hypertension. At his blood pressure review, readings are consistently 148/92 mmHg. He has no other medical conditions. According to NICE guidelines, what is the most appropriate next step?

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Correct answer: D — Increase amlodipine to 10 mg daily

NICE NG136 recommends optimising the dose of the current antihypertensive before adding a second agent (step 2). The maximum dose of amlodipine is 10 mg daily. If blood pressure remains uncontrolled at maximum dose, step 2 is to add an ACE inhibitor/ARB or a thiazide-like diuretic (indapamide preferred over bendroflumethiazide). Doxazosin and beta-blockers are reserved for resistant hypertension at step 4.

Reference: NICE NG136 Hypertension