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Question preview · RACGP Fellowship

A 58‑year‑old man with type 2 diabetes and BMI 31 kg/m² attends for review. On two separate visits his averaged seated blood pressure is 152/94 mmHg. He is a non‑smoker, eGFR 75 mL/min/1.73 m² with no albuminuria. According to contemporary Australian hypertension and cardiovascular risk guidelines, what is the most appropriate next step?

  1. A. Commence lifestyle measures only and review in 6 months
  2. B. Commence an ACE inhibitor now in addition to lifestyle modification
  3. C. Arrange 24‑hour ambulatory blood pressure monitoring and defer treatment until results are available
  4. D. Commence a beta blocker as first‑line monotherapy
  5. E. Reassure that this blood pressure is acceptable in a patient with diabetes

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