Fillers A patient who changed my practice

How we improved our treatment of hypertension

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7230.309 (Published 29 January 2000) Cite this as: BMJ 2000;320:309

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  1. Alexander Williams, general practitioner
  1. Exeter

    In my early years of general practice I was enthusiastic about controlling blood pressure. One particular patient, a retired civil servant, presented with a sore throat, and an incidental finding showed a blood pressure of 200/130.

    I was not sure how much of this was caused by meeting a new doctor so I took his blood pressure several times and it continued to be high. A general physical examination was unremarkable apart from a soft ejection systolic murmur at the left sternal edge. In particular, he had no protein in his urine and his fundi showed only grade 1 retinopathy. Baseline investigation showed his renal function was normal, mid—stream urine specimen was negative, and serum urate was normal. I initially started him on bendrofluazide at a dose of 5 mg a day, which was …

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