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Hypertension step-up therapy — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHypertension step-up therapyGPhC CRA

A 58-year-old woman takes amlodipine 10mg once daily. Clinic BP remains 156/92 mmHg and she has ankle swelling. eGFR is 70 mL/min/1.73 m2 and potassium is 4.2 mmol/L. What is the most appropriate alternative?

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Correct answer: E — Add ramipril and review oedema

Adding an ACE inhibitor is an appropriate next step when a calcium-channel blocker alone does not control BP. Verapamil with amlodipine is not a standard hypertension combination. Spironolactone is usually reserved for resistant hypertension with appropriate monitoring.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment