African American male, 63 years of age, type 2 diabetes, hypertension, strong family history of type 2 diabetes, hypertension and stroke. A1C is 6.7%. Blood pressure 160/96 HR 88, despite being on ACE-I and Beta Blocker.
Reviewed history, present lifestyle and medications.
Changed from ACE-I and Beta Blocker to thiazide diuretic and later calcium channel blocker. Responded well. Blood pressure now: 132/80 HR 78.
- Although RAS inhibitors are often the first choice for people who have diabetes, some African Americans don’t respond to them as well as to thiazide diuretics and or calcium channel blockers.
- JNC 8 Recommendation 7: In the general black population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or CCB. Retrieved from JAMA.
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