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A 55 year old athletic man visits his doctor for consultation. Recently he checked his blood pressure to be approved physically for a marathon. His blood pressure was 170/98. He proudly tells his physician that he has never had any healthy problem and didn't see any doctor for years. His family history is significant. His father died of a stroke at 62 years of age and his brother was diagnosed of hypertension when he was 39 and receives anti-hypertensive treatment. On physical examination, his BMI is 23, his pulse is 97/min and his blood pressure is 180/96 mmHg. His fundus examination shows grade II retinopathy. ECG demonstrates left ventricular hypertrophy with normal sinus rhythm. All his lab tests are normal.
What is the first line of treatment for this patient?
A- No treatment necessary and follow up after 3 months
B- Start doxazocin
C- Start hydralazine
D- Start Lisinopril
http://medical-usmle.com/?p=884
 
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