Your patient of 58 years of age has chronic hypertension.

Your patient of 58 years of age has chronic hypertension. You follow the guidelines for management as described by the American Heart Association and now have your patient fully medicated and dosed with three separate antihypertensive medications without control of the blood pressure. What should be your next step in the management of this patient?

 Physician consult?

add another medication?

Continue to observe for another three months?