Repeated USMLE Questions Step 1- 291

A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan.

In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient?







A calcium channel blocker is recommended in cases of hypertension accompanied by peripheral vascular disease such as Raynaud’s syndrome. Diltiazem and verapamil are the only calcium channel blockers in the above choices. Verapamil is preferred to diltiazem as the latter is associated with a long list of side effects including myocardial infarction (MI). Beta blockers such as atenolol and metoprolol are not recommended in patients with a history of bronchial asthma or any chronic pulmonary disease because of their bronchospasm effect. ACE Inhibitors as captopril are recommended for hypertensive patients with diabetes. They provide renal protection and delay the progress to diabetic nephropathy.

The correct answer is E

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