Question

A 58 year old man with type 2 diabetes and albuminuric chronic kidney disease has blood pressures around 148 over 86 mm Hg on repeated office readings. He is currently taking metformin and atorvastatin only. According to current diabetes and hypertension guidance, which is the most appropriate next step in managing his blood pressure?

Accepted Answer

Start a thiazide like hydrochlorothiazide and target blood pressure less than 140 over 90 mm Hg

Answer

Start an ACE inhibitor such as lisinopril and target blood pressure less than 130 over 80 mm Hg

Answer

Start a beta blocker such as metoprolol and target blood pressure less than 120 over 70 mm Hg

Answer

Start a calcium channel blocker alone and target blood pressure less than 135 over 85 mm Hg

Answer

Delay pharmacologic therapy and repeat blood pressure in 6 months

Practice question