Question

Let A = ACE inhibitor, B = beta blocker, C = calcium channel blocker, and D = diuretic. For an elderly patient with hypertension, the antihypertensive drug of choice is?

• A. A or D
• B. A or B
• C. A or C
• D. C or D

Hint:

Elderly patients are low-renin, so favour the renin-independent arm of the AB/CD rule.

Answer 1

The Correct Option is D

Step 1: Hypertension management can be remembered through the stepped AB/CD scheme. Drugs A (ACE inhibitor) and B (beta blocker) lower pressure by damping the renin-angiotensin axis, so they shine when renin is high. Drugs C (calcium channel blocker) and D (diuretic) reduce pressure through vasodilatation and sodium-volume offloading, working well when renin is low.

Step 2: Age shifts the renin profile. Older people characteristically run a low-renin, salt-sensitive form of hypertension, and the same is true for patients of African descent. Therefore the renin-independent pair, calcium channel blockers and diuretics, is preferred first-line for the elderly.

Step 3: Every other option keeps an A or a B in the answer, which steers toward the younger, high-renin patient. For the elderly the correct pairing is the volume-and-vasodilatation duo.

\[\boxed{\text{C or D (calcium channel blocker or diuretic)}}\]