70-year-old asymptomatic man with hypertension but not cardiovascular disease presented for a routine check. His pulse rate was 40bpm.  His son, aged 45, recently had an MI in Australia.

His medications include

• Doxazosin 8mg OD

• Metoprolol 95mg CR OD – since 2006

• Cilazapril 5mg / Hydrochlorothiazide 12.5mg OD

ECG shows sinus bradycardia, with normal PR interval, QRS duration.