I'm Taking My Pills; Why Does My BP Stay High?
A 60-year-old Caucasian male patient with a long-standing history of hypertension comes to the office for a follow-up. His current medications include furosemide, losartan, hydrochlorothiazide, aspirin, and a multivitamin. He is adherent with his medications and has been taking them at optimal doses for more than a year. He is complaining of excessive daytime sleepiness and fatigue. On exam, he is morbidly obese (body mass index of 43), his blood pressure is 158/90, his pulse is 72, his respiration rate is 18, and he has a right atrial oxygen saturation of 93%. The rest of his physical examination is unremarkable. His blood pressure (BP) has been consistently elevated above 150/90 during every office visit since the last year. His Epworth Sleepiness Scale score is 17. His current electrocardiogram shows evidence of left ventricular hypertrophy. His laboratory exam reveals normal hematology, chemistry, glycated hemoglobin, and thyroid levels. He undergoes an overnight polysomnography. His Apnea Hypopnea Index (AHI) number is 34 episodes per hour, which is consistent with severe obstructive sleep apnea (OSA).
Which of the following statements is incorrect?