Question

A 68-year-old man with type 2 diabetes and hypertension has an eGFR of 45 mL/min/1.73 m² and urine ACR 25 mg/mmol. BP is 142/88 mmHg on a thiazide-like diuretic alone. According to Diabetes Canada and Hypertension Canada guidance, what is the most appropriate next pharmacologic step?

Accepted Answer

Add an ACE inhibitor

Answer

Add a non-dihydropyridine calcium channel blocker

Answer

Add a beta-blocker as monotherapy

Answer

No change; BP control and albuminuria are adequate

Answer

Stop antihypertensives to preserve renal perfusion

Practice question

A 68-year-old man with type 2 diabetes and hypertension has an eGFR of 45 mL/min/1.73 m² and urine ACR 25 mg/mmol. BP is 142/88 mmHg on a thiazide-like diuretic alone. According to Diabetes Canada and Hypertension Canada guidance, what is the most appropriate next pharmacologic step?