The nurse is teaching a group of patients about hypertension. A patient who has been diagnosed with uncomplicated primary hypertension asks the nurse what the preferred initial antihypertensive drug regimen is. Which of the following is the nurse's best response?
a. Direct-acting vasodilators
b. Thiazide diuretics, as long as renal disease is not a factor
c. Two diuretics from two different groups
d. Beta blockers
ANS: B
According to The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP (JNC 7) guidelines, a thiazide diuretic is appropriate for use for uncomplicated primary hypertension to reduce blood volume and arterial resistance, as long as the patient does not have renal failure.
The use of two direct-acting vasodilators would result in excessive hypotension and would be contraindicated.
Two diuretics from different groups typically are not prescribed together unless potassium loss has been noted, because use of two diuretics may result in hypotension.
Use of a beta blocker no longer is indicated for uncomplicated primary hypertension unless the patient has heart disease.
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