What is the most appropriate medication change for a patient on valsartan and carvedilol who has elevated blood pressures post-myocardial infarction?

The most appropriate medication change for a patient on valsartan and carvedilol who has elevated blood pressures post-myocardial infarction is to add chlorthalidone 25 mg daily. Chlorthalidone is a thiazide diuretic that effectively lowers blood pressure by promoting the excretion of sodium and water, reducing blood volume, and consequently decreasing cardiac output. Combining a thiazide diuretic with an angiotensin receptor blocker (like valsartan) and a beta-blocker (like carvedilol) is a well-accepted strategy, particularly in post-myocardial infarction patients, as it enhances blood pressure control and reduces cardiovascular risk.

In the context of heart failure or post-myocardial infarction management, maintaining the use of valsartan and carvedilol is critical. They each serve significant roles in heart failure management and post-myocardial infarction treatment, providing benefits such as neurohormonal modulation and positive inotropic effects, thereby improving outcomes in these patients when blood pressure control is inadequate.

The other options, while they may address hypertension, are less appropriate in this context. Switching from valsartan to lisinopril does not combine as effectively or synergistically as adding a diuretic to