A hypertensive patient came to OPD today for a refill. He’d been taking the same meds since Dec 2021: T. Amlodipine 5mg (AM) and T. Telmisartan 40mg (PM).
When I asked to check his BP, he was visibly irritated and told me "It’s been 5 years, I take them religiously. It’s well-controlled." He hadn't seen a doctor or checked his BP since 2022....just monthly trips to the pharmacy.
I insisted. "This is a Govt Medical College; I don’t refill without a check-up."
Lo and behold: 170/100 mmHg.
I pushed for labs, and my gut feeling was right. Creatinine: 4.0, Urine protein: 2+, S. Potassium: 5.5. His kidneys are already failing because of "controlled" hypertension that wasn't actually controlled.
The kicker? We now have to overhaul his entire regimen because the Telmisartan he fought to refill has to be stopped; his renal function is too far gone.
Lesson: Adherence to pills is not equal to Adherence to follow-ups. Hypertension is a silent killer for a reason.