Question

A 68-year-old woman with a 15-year history of type 2 diabetes and microalbuminuria attends for follow-up. Her average home blood pressure over 2 weeks is 136-139/86-88 mm Hg. She is on metformin and lifestyle measures but no antihypertensives. According to current Canadian hypertension and diabetes guidelines, what is the most appropriate blood pressure management strategy?

Accepted Answer

Initiate an ACE inhibitor and aim for systolic blood pressure below 130 mm Hg if tolerated

Answer

Reassure her that blood pressure is acceptable and recheck in one year

Answer

Initiate a low-dose beta-blocker as first-line therapy

Answer

Delay drug therapy until systolic blood pressure is persistently >=150 mm Hg

Answer

Start a thiazide diuretic only if diastolic blood pressure exceeds 100 mm Hg

Practice question