An eighty-one-year-old man presents for follow-up after thre…
An eighty-one-year-old man presents for follow-up after three falls in the past two months. He lives alone, uses a cane outside the home, and denies loss of consciousness with the falls. He reports feeling “lightheaded” when he stands up quickly. His medications include a long-acting beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and a thiazide diuretic for hypertension, plus a daily multivitamin. Supine blood pressure: 112/62 millimeters of mercury; pulse 60. Standing blood pressure (one minute): 92/56 millimeters of mercury; pulse 62. Neurologic examination is nonfocal, and his gait is slow but not clearly ataxic. Which management step is the most appropriate first action in primary care to reduce his future fall risk?