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Hypertension in type 2 diabetes — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHypertension in type 2 diabetesGPhC CRA

A 58-year-old woman with type 2 diabetes has confirmed hypertension with an average ABPM of 152/94mmHg. She has urine ACR 8mg/mmol, potassium 4.4mmol/L and eGFR 78mL/min/1.73m2. She has NKDA and takes metformin. What is the most appropriate action?

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

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Correct answer: A — Start ramipril and arrange renal function and potassium monitoring

In type 2 diabetes with hypertension, an ACE inhibitor or ARB is generally preferred, particularly with albuminuria. Baseline renal function and potassium are suitable for cautious initiation. Urea and electrolytes should be checked after starting or increasing the dose because ACE inhibitors can increase creatinine and potassium.

Reference: NICE CKS; BNF