The first-line drug for treating this client's blood pressure might be which drug?

• A. Diuretic
• B. Alpha blocker
• C. ACE inhibitor
• D. Alpha/beta blocker

Answer: (A)

A thiazide-type diuretic is a common first-line choice because it lowers blood pressure by reducing circulating fluid, which lowers preload and, with time, decreases systemic vascular resistance. This mechanism translates into real cardiovascular risk reduction (like fewer strokes) and has a long, strong evidence base. They’re inexpensive and generally well tolerated, making them a practical starting therapy for uncomplicated hypertension.

Alpha blockers can cause orthostatic hypotension and have weaker evidence for reducing cardiovascular events when used alone, so they’re not favored as initial therapy. Alpha/beta blockers are typically reserved for specific situations or comorbidities rather than first-line for uncomplicated hypertension. ACE inhibitors are effective and protective for some patients, especially with diabetes or kidney concerns, but in a general, uncomplicated case, a thiazide diuretic’s balance of efficacy, safety, and cost makes it the preferred starting option.