A 61-year-old Black male with a history of hypertension presents to your clinic for complaints of headaches

A 61-year-old Black male with a history of hypertension presents to your clinic for complaints of headaches and blurred vision x 4 days. He denies any weakness, numbness, chest pain, shortness of breath, palpitations, or recent, illicit drug use. He states he has been compliant with his medications (hydrochlorothiazide and metoprolol), and he took his meds this morning.

If I continue the patient on metoprolol and hydrochlorothiazide, what would I anticipate prescribing or changing to manage the current blood pressure elevation despite his medications, if his vital were:

B/P 190/100, P- 90, T- 98.9, R- 22. Recent labs show that TC- 260, LDL-190, HDL- 35, Trig- 320.

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