Essential Hypertension — RACP Adult Medicine MCQ

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ModerateCardiologyEssential HypertensionRACP Adult Medicine

A 45-year-old woman with essential hypertension and a history of gout presents with BP 160/95 mmHg. She has no proteinuria or diabetes. Which antihypertensive class should be avoided?

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Correct answer: B — Thiazide diuretic

Thiazide diuretics reduce uric acid excretion and can precipitate gout flares. They should be avoided or used with caution in patients with a history of gout. A calcium channel blocker or ACEi/ARB would be more appropriate first-line agents in this patient. Losartan uniquely among ARBs has a mild uricosuric effect.

Reference: eTG Cardiovascular – 2024 – Hypertension