A 35-year-old African American man has a new diagnosis of hypertension during an annual examination. He has unremarkable medical history, and no chronic medications use. His both parents are diabetics and hypertensive. On examination, BMI 32, HR 76/min, and BP 160/90mmHg. The rest of the physical examination is unremarkable for end-organ damage. Which of the following is the best initial treatment for his hypertension based on the JNC8 hypertension guideline?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Hydrochlorothizide
For African American (Black) patients, JNC 8 recommends a thiazide-type diuretic or a CCB as initial therapy, so hydrochlorothiazide is correct. Ramipril (ACE-I) is the preferred first drug in non-Black patients <55 or those with DM/CKD, which he does not have. Beta-blockers are not first line without a cardiac indication, and spironolactone is reserved for resistant hypertension.
ليش كل خيار صح أو غلط
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A
ليش صح
For African American patients the choice is a thiazide-type diuretic or a CCB, so hydrochlorothiazide fits.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 7 -
B
ليش غلط
Beta blockers should not be used as first line except in CAD.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 7 -
C
ليش غلط
ACE inhibitors are preferred in non-African American patients under 55 (and in DM, CKD, CHF/CAD); African American patients get a thiazide-type diuretic or CCB.
✓ Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 7 -
D
ليش غلط
Spironolactone (a mineralocorticoid receptor antagonist) is an add-on option for resistant hypertension, not an initial drug.
✓ Step Up To Medicine 6th (Hypertension).pdf · p. 6
- المصدر
- Dr. Al-Ahmadi - HTN and Hypertensive Emergency✅.pdf · p. 7
- المحاضرة
- Hypertension · Cardiology · Module B
- ظهر في
- Cardio bank