Confusion regarding essential hypertension - hopetomatchsoon

[ArchivalUser]

According to MTB, HCTZ is the first line treatment for essential hypertension except for diabetics, where ACE inhibitors are the first line in this case. However when I read one of the UW ccs case explanations, it says that ACE inhibitors are the first line treatment while CCBs are preferred in African Americans. So which one is right?

[ArchivalUser]

Anybody?

[ArchivalUser]

As per JNC 8 guidelines , first drug of choice is ACEI as long as there are no contraindications like renal etc.,

[ArchivalUser]

let me check "next step in management" book.

[ArchivalUser]

I asked this question a while ago and I'm still not 100% what the correct answer is. So is it indeed ACE inhibitor?

[ArchivalUser]

I think the question will tell you which one. i.e contraindications to ACEi or CCB's. What MTB says is go with the information in the question stem tells you same with JNC if you look at it. I do remember that when no contraindication exists then you start with HCTZ.

This is my opinion...correct me if i'm wrong