What is your initial choice for an antihypertensive medication in this patient?

What is your initial choice for an antihypertensive medication in this patient?

What is your initial choice for an antihypertensive medication in this patient? 150 150 Nyagu

J.S. is a 54-year-old Hispanic woman who presents to her primary-care clinician for follow-up regarding elevated blood pressure. She was last seen 2 weeks prior with a blood pressure of 162/94 mmHg. She has no significant medical history, she is a 1 ppd tobacco user with a history of 25 pack-years, and she has a family history of premature cardiac death.

Evaluation:

Her vital signs are as follows: height, 5 ft 4 in.; weight, 188 lb.; pulse, 84 beats/min; blood pressure, 168/98 mmHg; and body mass index, 32.3. As J.S. has been found to be hypertensive (>149/90) on two consecutive office visits, starting an antihypertensive medication is indicated.

Questions:

What is your initial choice for an antihypertensive medication in this patient? (Support your treatment plan with a discussion of the evidence based guideline you utilized)
Which therapeutic lifestyle change is a priority in helping J.S. achieve blood pressure control?
Which of the following diagnostic tests would you order for J.S. to establish a baseline before starting an anti-hypertensive?