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Diabetic hypertension with albuminuria — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsDiabetic hypertension with albuminuriaGPhC CRA

A 52-year-old man with type 2 diabetes has clinic BP readings around 152/92 mmHg and ACR 9 mg/mmol. He is prescribed indapamide MR 1.5 mg daily; eGFR is 82 mL/min/1.73 m2 and potassium 4.6 mmol/L. What is the most appropriate alternative?

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Correct answer: D — Ramipril

In diabetes with albuminuria, ACE inhibitor therapy is generally preferred because it treats hypertension and provides renal protection. The renal function and potassium are acceptable for initiation with monitoring. Indapamide may be useful later, but it is less appropriate as first choice in this scenario.

Reference: NICE CKS; BNF