**Core Concept**
The question requires the selection of an appropriate antihypertensive agent for initial therapy in a patient with hypertension and angina pectoris, considering the patient's tense personality and resting heart rate of 96/min.
**Why the Correct Answer is Right**
The patient's presentation suggests a high sympathetic tone, likely contributing to his hypertension and angina. An ideal antihypertensive agent for this patient would be one that can reduce sympathetic tone, lower blood pressure, and minimize the risk of worsening angina. **Beta blockers** are a suitable choice as they reduce heart rate, lower blood pressure, and decrease myocardial oxygen demand by reducing heart rate and contractility.
**Why Each Wrong Option is Incorrect**
* **Option A:** **Diuretics** may be effective in reducing blood pressure, but they do not address the patient's high sympathetic tone or myocardial oxygen demand, making them a less suitable choice for initial therapy.
* **Option B:** **ACE inhibitors** and **ARBs** are effective in reducing blood pressure and may be beneficial in patients with heart failure or proteinuria, but they do not directly address the patient's high sympathetic tone or myocardial oxygen demand.
* **Option D:** **Calcium channel blockers** may be beneficial in patients with angina by reducing myocardial oxygen demand, but they may not be as effective in patients with high sympathetic tone.
**Clinical Pearl / High-Yield Fact**
When managing patients with hypertension and angina, it is essential to consider the patient's overall cardiovascular risk profile, including their heart rate, blood pressure, and lipid profile, to select the most appropriate antihypertensive agent.
**Correct Answer: C. Beta blockers**
Free Medical MCQs · NEET PG · USMLE · AIIMS
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