58F follow-up for hypertension and T2DM. Reports mild headaches over the past 2 weeks, occasional dizziness on standing. Adherent to medications. Monitoring home BP 140s/80s. Appetite and sleep unchanged. No chest pain, dyspnoea, or peripheral oedema.

Alert, well-appearing. BP 138/84 seated, 132/80 standing. HR 78 regular. RR 16. SpO2 97% RA. Heart: RRR, no murmurs. Lungs: clear. Abdomen: soft, non-tender. Extremities: no oedema. Random finger-prick glucose 8.2 mmol/L.

1. HTN — sub-optimal control, likely contributing to headaches. 2. T2DM — reasonable control, last HbA1c 7.1%. 3. Hyperlipidaemia — on atorvastatin. 4. Osteoporosis — stable on alendronate.

• Increase amlodipine to 10 mg daily (was 5 mg). • Continue metformin 1 g BD, atorvastatin 40 mg nocte. • Home BP log — target <135/85. • Repeat HbA1c, lipids, U&E in 3 months. • Fasting glucose and microalbumin next visit. • Flu vaccine due — administer today. • Return in 8 weeks.