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Stage 2 hypertension — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsStage 2 hypertensionGPhC CRA

A 46-year-old man of Black African family origin has newly diagnosed hypertension. ABPM daytime average is 158/96 mmHg. eGFR is above 60 mL/min/1.73 m2 and he has no diabetes or regular medicines. What is the most appropriate alternative?

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Correct answer: D — Amlodipine

A calcium-channel blocker is appropriate first-line treatment in this scenario. ACE inhibitors may be less effective as initial monotherapy in adults of Black African or African-Caribbean family origin unless there is a compelling indication. The other medicines may have roles later but are less suitable as first-line treatment here. The keyed option is to contact the prescriber before supply because additive QT prolongation is unsafe.

Reference: NICE CKS; BNF