A 46-year-old man is evaluated during a follow-up visit for elevated blood pressure. His average blood pressure with home monitoring is 126/77 mm Hg. He has no other pertinent medical history and takes no medications. On physical examination, blood pressure is 128/78 mm Hg; other vital signs are normal. BMI is 28. The remainder of the examination is unremarkable.

Which of the following is the most appropriate next step in management?

1) Initiate therapy with an angiotensin receptor blocker
2) Initiate therapy with a thiazide diuretic
3) Initiate a trial of lifestyle modification
4) Remeasure blood pressure in 1 year

Given the patient's relatively modest blood pressure elevation, absence of comorbidities, and the emphasis on non-pharmacological interventions in current guidelines, initiating a trial of lifestyle modification is a prudent first step to address elevated blood pressure effectively.So the correct option is 3 .Initiate a trial of lifestyle modification.

Explanation:

Given the patient's blood pressure readings and lack of other medical conditions, lifestyle modification is the most appropriate initial step. This approach aligns with current guidelines, emphasizing non-pharmacological interventions for mild hypertension. Lifestyle modifications may include dietary changes, exercise, and weight management to address the elevated blood pressure. Pharmacotherapy is generally considered when lifestyle modifications alone are insufficient or in more severe cases. In this scenario, the relatively modest elevation in blood pressure and absence of comorbidities make lifestyle changes the preferred initial strategy.

Lifestyle modifications play a crucial role in managing mild hypertension. These interventions, such as adopting a heart-healthy diet, regular exercise, and weight control, contribute to blood pressure control and overall cardiovascular health. It's important to tailor the approach to the individual patient's needs and consider the potential impact on long-term health outcomes.So the correct option is 3 .Initiate a trial of lifestyle modification.

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