3rd HTN Q - dalia2010

[ArchivalUser]

Which of the following scenarios illustrates the most appropriate first-line
selection of antihypertensive agent in the hypertensive patient described below?

A. A 72- year-old man with gout is prescribed a diuretic

B. A 35- year-old woman, pregnant with her first child, is prescribed lisinopril

C. A 32- year-old with chronic migraines is prescribed metoprolol

D. A 76- year-old woman with a history of femoral artery bypass surgery is
prescribed atenolol

E. A 42- year- old woman with newly diagnosed Graves’' disease is prescribed a
diuretic

[ArchivalUser]

dd

[ArchivalUser]

D.

[ArchivalUser]

dd

[ArchivalUser]

C

[ArchivalUser]

ccc

[ArchivalUser]

i will pick C

[ArchivalUser]

C

[ArchivalUser]

Answer: C. Most experts agree that first-line antihypertensive therapy should
usually consist of a diuretic or B-blocker. There are certain compelling indications,
however, to choose a different agent. Use of a B-blocker in a patient with chronic
migraines may serve to both control blood pressure and also prevent migraines.
Likewise, there are relative contraindications to some agents. A diuretic can increase
uric acid levels and thus worsen gout. Lisinopril is contraindicated in pregnancy. B-
blockers can worsen peripheral vascular disease and should be avoided in a patient
with a history of femoral bypass. Finally, a young woman with newly diagnosed
Graves’ disease may be better served by a B-blocker (rather than a diuretic) to
control both blood pressure and heart rate.

[ArchivalUser]

thanks for the nice que and explanation dalia2010