Question

A 55-year-old man with type 2 diabetes mellitus for 6 years attends for review. His automated office blood pressure averages 138/84 mm Hg despite lifestyle measures. He has no albuminuria, cardiovascular disease, or other comorbidities. According to Canadian guidelines, what is the most appropriate management?

Accepted Answer

Initiate an ACE inhibitor aiming for a blood pressure target below 130/80 mm Hg.

Answer

Reassure him that his blood pressure is at target and make no change.

Answer

Initiate a beta blocker aiming for a blood pressure target below 140/90 mm Hg.

Answer

Initiate a thiazide only if blood pressure rises above 160/100 mm Hg.

Answer

Avoid blood pressure medications in diabetes until there is albuminuria.

Practice question