Skill Checkup: A 59-Year-Old Male With Overweight, Hypertension, and Increased Urine Output

Anne L. Peters, MD


December 23, 2022

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 59-year-old Hispanic male presents to his primary care physician complaining of polyuria for the past 3 months with both increased urine output and an increased number of trips to the restroom to urinate, including multiple times during the night.

The patient is considered overweight. He is 5 ft 8 in (1.73 m), weighs 190 lb (86.18 kg; with a body mass index of 28.9), and has long-standing hypertension. He was first diagnosed with hypertension 10 years ago (his blood pressure was 190/100 mmHg prior to initiating therapy) and has not been able to control his blood pressure well or get it < 132/85 mmHg. He is also prediabetic; at his last screening 15 months ago, his hemoglobin A1c (HbA1c) was 6.2%, and his fasting glucose was 120 mg/dL. The patient is a nonsmoker and a coffee drinker; he drinks one cup of coffee per day. He is currently taking metformin 500 mg daily for type 2 diabetes prevention (off-label) and hydrochlorothiazide 12.5 mg/daily for his hypertension.


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