text_1: 72-year-old man with hypertension.  He is on Lotrel 5/20, Atenolol 100 milligrams, Cardura 4 milligrams and hydrochlorothiazide 12.5 milligrams.  His blood pressure today is 166/72 by the nurse and I got 180 systolic.  The question is where to go from here with his antihypertensives.
text_2: How should the antihypertensives be changed in a patient not controlled on an angiotensin-converting-enzyme inhibitor, a beta blocker, an alpha blocker, and a thiazide diuretic?