AKT-5503

AKT-5503

A 65-year-old man presents to the GP clinic for follow-up. He reports experiencing shortness of breath on exercise, which has worsened over the past few months. He can now only walk 200-300 yards on flat ground and has difficulty climbing stairs. The patient has a history of hypertension and is currently taking amlodipine 5 mg and indapamide 2.5 mg. In the clinic, his blood pressure is 195/90, and he has bibasal crackles indicative of heart failure, but no ankle edema is present.

The following investigations were conducted:
– Haemoglobin: 139 g/L (115-165)
– White cells: 7.1 ×109/L (4-11)
– Platelets: 203 ×109/L (150-400)
– Sodium: 139 mmol/L (135-146)
– Potassium: 4.3 mmol/L (3.5-5)
– Creatinine: 129 μmol/L (79-118)
– Ejection fraction: 55%

What is the most appropriate next therapy for this patient?