E N D
Hypertension Routine annual exam: active nonsmoker 76 yr old research physician BP 186/92. Previous BP was 120-135/66-78. Infrequent palpitations; no headache, visual or vascular symptoms. FH: longevity, no cvasc disease. Phys Exam: 188-204 lbs normal cvascular, retinal, blood tests, renal arterial flow, EKG. Initial treatment: salt restriction, diuretic, increased exercise, weight reduction; ACE inhibitor produced hypotensive collapse in restaurant! Replaced by calcium channel blocker….4yrs later, BP 122/68.