skip to main content

Hypertension first-line treatment — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiovascular TherapeuticsHypertension first-line treatmentGPhC CRA

A 58-year-old man of black African family origin attends the pharmacy after ABPM confirmed stage 2 hypertension. His eGFR is 78mL/min/1.73m2, potassium is 4.4mmol/L and he has no diabetes or heart failure. He asks what treatment the GP is likely to start. 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 — amlodipine 5mg once daily

Calcium-channel blockers are first-line antihypertensive treatment for adults aged 55 years or over and for adults of black African or African-Caribbean family origin without type 2 diabetes. His renal function and potassium do not force a different choice. An ACE inhibitor would be a common first-line option in a younger non-black patient, but is less appropriate here. Beta-blockers and alpha-blockers are not routine first-line options for uncomplicated hypertension.

Reference: BNF; NICE CKS: Hypertension