The CME “snow bird” case was written to illustrate the importance of treating hypertension and to illustrate that compliance with medication depends on the physician being aware of side effects and taking appropriate action; that treatment of hypertension after stroke is important (particularly as treatment of many stroke patients remains inadequate); and to describe the role of ambulatory blood pressure monitoring in hypertension management. The mention of an individual generic drug name was removed from the online version of this case as soon as it was brought to our attention via Dr. Lexchin's letter to the College.
Despite Dr. Lexchin's assertion that in the absence of diabetes most patients with hypertension should be treated with a thiazide diuretic, in practice many patients experience side effects from thiazines or have contraindications to thiazides such as gout, refractory hypkalemia or renal impairment.1 The case presents options for the management of this type of patient.
Competing interests: Dr. Dawes received payment from the CME office at McGill for writing the original case. This funding was provided by mdBriefCase and does not represent direct pharmaceutical funding.