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Resistant hypertension — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsResistant hypertensionGPhC CRA

A patient with clinic blood pressure 166/94 mmHg is already taking amlodipine, ramipril and indapamide at tolerated doses. Recent potassium is 4.1 mmol/L. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Spironolactone after prescriber confirmation and renal monitoring

Low-dose spironolactone is a recognised option in resistant hypertension when potassium and renal function permit. The best answer addresses the key safety, legal or pharmaceutical care issue in the vignette. The other options would either delay appropriate care, create a new risk, or fail to resolve the issue. This is consistent with the cited UK reference for safe pharmacy practice.

Reference: BNF; NICE CKS