A 62-year-old man with hypertension is found to have a blood pressure of 148/86 mm Hg after optimizing his medication. Which action is recommended?

In managing hypertension, particularly in patients who have already undergone medication optimization, it is essential to evaluate current blood pressure readings in the context of established guidelines. For a 62-year-old man with a blood pressure of 148/86 mm Hg, which is above the typical target range for most adults (generally, less than 130/80 mm Hg for those with hypertension), action is warranted.

Adding an angiotensin receptor blocker is a recommended strategy because these medications can further help to improve blood pressure control, especially in older adults who may have other comorbidities such as heart failure, diabetes, or kidney disease. Angiotensin receptor blockers (ARBs) are effective at reducing cardiovascular risk and can provide renal protection, making them beneficial for patients who might have underlying conditions.

The current reading indicates that the patient is not at goal. Therefore, while switching to a calcium channel blocker or adding a beta blocker could be reasonable adjustments depending on the patient's individual health factors, the addition of an ARB specifically aligns with current hypertension treatment guidelines that advocate for multi-drug therapy in patients not reaching target blood pressure with their current regimen.

Maintaining the current regimen is not advisable either, as achieving the target blood pressure is paramount in reducing