A hypeensive, diabetic is having proteinuria, antihypeensive of choice is-
**Core Concept**
In patients with hypertension and diabetes, the presence of proteinuria indicates underlying renal damage, often due to diabetic nephropathy. The primary goal of antihypertensive therapy in such cases is to slow the progression of renal disease while controlling blood pressure.
**Why the Correct Answer is Right**
The angiotensin-converting enzyme (ACE) inhibitors are a preferred class of antihypertensive agents in patients with proteinuria and diabetes. They work by inhibiting the conversion of angiotensin I to angiotensin II, thereby reducing the pressure within the glomerular capillaries and decreasing proteinuria. This class of drugs also has a beneficial effect on the renin-angiotensin-aldosterone system (RAAS), which is often activated in patients with diabetic nephropathy.
**Why Each Wrong Option is Incorrect**
**Option A:** Diuretics are not the preferred initial choice in patients with proteinuria and diabetes, as they can worsen renal function by reducing renal perfusion and increasing glomerular pressure.
**Option B:** Beta-blockers may be used in combination with other antihypertensive agents but are not the first-line choice in patients with proteinuria and diabetes, as they do not have a direct beneficial effect on renal function.
**Option C:** Calcium channel blockers can be used as alternative antihypertensive agents but are not the preferred choice in patients with proteinuria and diabetes due to their potential to worsen renal function in certain cases.
**Clinical Pearl / High-Yield Fact**
ACE inhibitors are a "renal-sparing" class of antihypertensive agents, meaning they can slow the progression of renal disease and reduce the risk of end-stage renal disease (ESRD) in patients with proteinuria and diabetes.
**Correct Answer:** C.