In a patient with uncontrolled hypertension taking multiple medications, what is the best next action?

In patients with uncontrolled hypertension, it's crucial to consider all contributing factors that may be influencing their blood pressure control. The correct approach involves assessing and addressing any potential medication interactions, lifestyle factors, or other underlying conditions that could be exacerbating hypertension.

In this case, the choice to discontinue ibuprofen and start acetaminophen is significant. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can lead to sodium retention and fluid overload, which may worsen hypertension, especially in patients already taking multiple antihypertensive medications. By switching to acetaminophen, which has a more favorable profile for someone with hypertension, the patient may have fewer risks of exacerbating their high blood pressure.

It's important to remember that the management of hypertension requires a comprehensive approach, often involving the optimization of current therapeutic regimens while minimizing potentially harmful medications. Thus, changing the patient's analgesic to something that does not interfere with blood pressure can be a necessary step in obtaining better control over their hypertension.

The other options may not effectively address the immediate contributors to the patient’s uncontrolled blood pressure or may complicate their medication regimen further without sufficient evidence to justify the switch or dose adjustment.