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Hypertension and type 2 diabetes — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHypertension and type 2 diabetesGPhC CRA

A 58-year-old man with type 2 diabetes and persistent albuminuria has blood pressure above target. The GP asks which first-line class is most appropriate. What is the most appropriate alternative?

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

Reveal the answer and explanation

Correct answer: A — An ACE inhibitor such as ramipril

ACE inhibitors are commonly preferred in diabetes with albuminuria because they provide renal and cardiovascular benefit in addition to blood pressure reduction. Renal function and potassium should be monitored. Loop diuretics and nitrates are not usual first-line choices for uncomplicated hypertension with albuminuria. Potassium supplementation is not an antihypertensive treatment.

Reference: NICE CKS; BNF