A 45-Year-Old Man Comes to the Office for Routine Follow-Up

A 45-year-old man comes to the office for routine follow-up.  The patient was diagnosed with hypertension and hypercholesterolemia a year ago and is taking hydrochlorothiazide and amiloride daily.  He currently feels well.  He does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 135/85 mm Hg.  Physical examination is unremarkable.  Laboratory results are as follows: There was no evidence of hemolysis when the blood sample was checked by the laboratory technician.  ECG demonstrates normal sinus rhythm with no other abnormalities.  Which of the following is the most appropriate next step in management of this patient?

A) Change amiloride to amlodipine and recheck laboratory results in a week
B) Change hydrochlorothiazide to amlodipine and recheck laboratory results in a week
C) Instruct the patient to take daily oral calcium carbonate
D) Start intravenous dextrose and insulin
E) Tell the patient to start a low-potassium diet

Correct Answer:

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