Step III Hypertension management

Started by jwars6
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jwars6

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had a question about management that i saw on my test today. basically, a guy comes in for routine physical in his 40s, has hypertension in 150s/90s but otherwise completely healthy, has a family history of diabetes and coronary artery disease, but has no past medical history himself. what antihypertensive would you start? a thiazide? an ACE? I know first line is a thiazide for primary hypertension without risk factor, but with his family history i didn't know if that warranted an ACE. It did explicitly state his bg was wnl.

Thanks!
 
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jwars6 said:
had a question about management that i saw on my test today. basically, a guy comes in for routine physical in his 40s, has hypertension in 150s/90s but otherwise completely healthy, has a family history of diabetes and coronary artery disease, but has no past medical history himself. what antihypertensive would you start? a thiazide? an ACE? I know first line is a thiazide for primary hypertension without risk factor, but with his family history i didn't know if that warranted an ACE. It did explicitly state his bg was wnl.

Thanks!
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Lifestyle modification + recheck.

JNC late should come out sometime soon, as people have been saying as long as I have been a student. It will supplant beta blockers and thiazides in favor of ACEi/ARB and CCBs.
 
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