The primary care NP sees a new African-American patient who has blood pressure readings of 140/90 mm Hg, 130/85 mm Hg, and 142/80 mm Hg on three separate occasions. The NP learns that the patient has a family history of hypertension. The NP should:
a. initiate monotherapy with a thiazide diuretic.
b. prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor.
c. discuss dietary and lifestyle modifications with the patient.
d. begin combination therapy with an ARB and a calcium-channel blocker.
A
African Americans tend to respond better than whites to diuretic monotherapy, so this is an appropriate starting therapy. Calcium-channel blockers and ARBs are preferred as adjunct medications in African Americans.
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