24th April 2024

A 67-year old gentleman has persistent chest tightness on exertion despite recent titration to atenolol 100mg BD.

A 67-year old gentleman has persistent chest tightness on exertion despite recent titration to atenolol 100mg BD. He has a past medical history of hypertension and type 2 diabetes, managed by lifestyle modifications alone. His most recent ambulatory blood pressure readings average at 130/80mmHg, and his HbA1C taken last month was 46 mmol/mol. Aside from atenolol, he takes atorvastatin 80 mg OD, aspirin 75mg OD and ramipril 10mg OD. What is the next best step in his management? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.