Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the recommended first-line medication for hypertension in patients older than 55 or who are Black?

1. ACE Inhibitor

2. Calcium Channel Blocker

3. Statin

4. Beta Blocker

The correct answer is: Calcium Channel Blocker

The recommended first-line medication for hypertension in patients older than 55 or who are Black is a calcium channel blocker. This recommendation is based on clinical guidelines, which indicate that calcium channel blockers are effective in managing high blood pressure in specific populations, particularly among older adults and Black patients. The effectiveness of calcium channel blockers in these demographics stems from their ability to induce vasodilation and lower systemic vascular resistance, leading to a reduction in blood pressure. Studies have shown that these medications can effectively lower blood pressure without the adverse effects sometimes associated with other classes of antihypertensives. In contrast, while ACE inhibitors can be beneficial, they are often not the first choice for these specific groups due to variable responses and a higher propensity for side effects such as cough and angioedema, especially in Black populations. Statins are primarily used for cholesterol management and cardiovascular risk reduction rather than for the treatment of hypertension. Beta blockers are generally reserved for certain conditions like heart failure or post-MI scenarios rather than acting as first-line agents for hypertension, particularly in older adults or Black individuals. Overall, the preference for calcium channel blockers in these cases is supported by clinical evidence and guidelines, making them the suitable first-line therapy for the specified patient populations.