Question

A 63-year-old woman with long-standing type 2 diabetes and albuminuric chronic kidney disease (ACR 60 mg/mmol, eGFR 45 mL/min/1.73 m²) has a clinic BP of 138/82 mm Hg on lifestyle measures alone. According to Canadian hypertension and diabetes guidelines, what is the most appropriate management of her blood pressure?

Accepted Answer

Start an ACE inhibitor and target BP <130/80 mm Hg

Answer

No pharmacologic treatment because BP is below 140/90 mm Hg

Answer

Start a thiazide diuretic alone and target BP <140/90 mm Hg

Answer

Start dual therapy with beta blocker and calcium channel blocker

Answer

Start an ARB only if BP rises to ≥150/90 mm Hg

Practice question