THE CASE: A 65-year-old woman who is a longtime patient comes in for a routine checkup. Her primary problem is hypertension, which is well controlled with atenolol and hydrochlorothiazide. During the past 10 years, her weight has increased from 140 to 165 lb and her height has declined from 5 ft 2 in to 5 ft ½ in. She mentions that at age 79 years, her mother had to move to a nursing home after a hip fracture and was not able to live independently again. The patient wants to avoid a similar outcome. She lives alone, dines out frequently, and is sedentary.
What steps can this patient take now to improve her health and quality of life and to maintain her independence?
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