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Clinical Crossroads
June 24, 1998

A 42-Year-Old Man With Hypertension, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 1998;279(24):1998. doi:10.1001/jama.279.24.1998

At the Medicine Grand Rounds held in May 1997, Suzanne Oparil, MD, discussed the evaluation and management of a 42-year-old African American man with poorly controlled hypertension, first diagnosed 14 years previously.1 With blood pressures as high as 180/130 mm Hg since 1995, he had received sporadic care. At the time of the Rounds, he was obese, sedentary, hypertensive, and stressed by a difficult home and work environment, but insured through a commercial managed care program. An exercise tolerance test showed left ventricular hypertrophy and mild global hypokinesis, but there was no physical or laboratory evidence for other end-organ disease.

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