Interactive diabetes case 20: A 76-year-old patient with longstanding type 2 diabetes, orthostatic hypotension, and recurrent syncope – C3

ANSWER — 

Incorrect.

The patient under consideration currently has marked supine systolic hypertension. It is unwise to stop lisinopril at this time and risk a further rise in supine systolic values. The substitution of an agent whose effective dose and tolerability in this patient are not yet known is also not well advised.

While beta-adrenergic antagonists may be helpful in patients with autonomic orthostatic hypotension, they are not first-line agents for this disorder.

Return to the previous choice to try again. (See "Interactive diabetes case 20: A 76-year-old patient with longstanding type 2 diabetes, orthostatic hypotension, and recurrent syncope – B3".)