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Hypertension initiation — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHypertension initiationGPhC CRA

A 48-year-old man with confirmed clinic BP 152/94 mmHg has type 2 diabetes and no albuminuria. His latest eGFR is 82 mL/min/1.73 m² and potassium is normal. The GP asks which first antihypertensive to start. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Ramipril once daily

An ACE inhibitor such as ramipril is a suitable first-line choice in a patient with diabetes and hypertension, provided renal function and potassium are checked. Calcium-channel blockers or thiazide-like diuretics may be used where ACE inhibitors are unsuitable. Beta-blockers and alpha-blockers are not usual first choices for uncomplicated hypertension.

Reference: BNF; NICE CKS