A 48 yo female came to your urgent care clinic complaining of stress, swollen face, swollen lips, hoarseness of voice, some difficulty breathing, episodes of abdominal pain, and watery diarrhea for the last one week. Her current medications include lisinopril for hypertension and paroxetine for anxiety and obsessive compulsive disorder. She has been taking lisinopril 10 mg daily for over 10 years and paroxetine 20 mg daily for over 6 years. Her vital signs were Temperature 97.7 F, Respiratory rate 19/minute, Pulse 75/minute, BP 118/78 mm Hg. Her physical examination is significant for swollen lips, swollen face and tenderness in all quadrants of abdomen with palpation. Suspecting angioedema, you ordered serum C4 level, which gave a result of 4 mg/dl (normal 12 – 38 mg/dl). Her symptoms subsided over the next few days. Going forward, how would you manage her high blood pressure?
