What Is the Best Anti-Hypertension Drug in This Case and Why?

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MR M.A is a healthy 36-year old obese male.his BP was found of 178/114 mmhg. He is a heavy smoker and drinks 10 or more units of alchohol each evening. He has a sedentary occupation.
what anti hypertension agent coud be used in initial management of his hypertension?

1 comment… read it below or add one

Troy January 31, 2009 at 4:49 am: First thing is you cannot diagnose hypertension from a single reading. You need at least two more.
If he does have hypertension, the first thing is he needs to stop drinking so much, exercise more, lose weight, and stop smoking. Lifestyle modifications always come first. you wouldn't let a 300 pound person keep eating 4000 Cal. a day, why would you not counsel this patient to stop his destructive habits?
All of the above answers are at least partially correct. a 36 year old with stage II hypertension should be evaluated for a secondary cause. If one is found then you treat based on that. a Pheochromocytoma would be treated with surgical resection and an alpha 1 and beta blocker. Renal artery stenosis would be treated medically with ACE inhibitors ro angiotensin receptor blockers if possible, otherwise surgical correction would be necessary
Beta blockers and CCBs are no longer recommended as first line agents, he should be put on a or a thiazide diuretic, probably including an ACE-Inhibitor with that high of a blood pressure. If those don't bring down the BP enough then a CCB or beta blocker would be added.