Repeated USMLE Questions Step 2 CK- 433

A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits.  He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg.

What is the most appropriate treatment for this patient’s hypertension?

A – Lisinopril 10 mg daily

B – Metoprolol 25 mg daily

C – Hydralazine 50 mg daily

D – Minoxidil 30 mg daily

E – Continue lifestyle modification for 3 months

Answer



The rule of thumb in treating hypertension in diabetic patients is using ACE inhibitors such as Lisinopril to delay renal problems. Other antihypertensive drugs do not help to delay the development of diabetic neuropathy. Lifestyle modification is not enough for this patient at this time.

The correct answer is A



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