In a patient with hypertension and type 2 diabetes, which antihypertensive class is preferred for renal protection?

• A. ACE inhibitors
• B. Calcium channel blockers
• C. Thiazide diuretics
• D. Beta blockers

Answer: (C)

In a patient with hypertension and type 2 diabetes, protecting kidney function hinges on drugs that reduce pressure inside the glomeruli and curb albumin leakage. ACE inhibitors achieve this by blocking angiotensin II, which relaxes the efferent arteriole. This lowers intraglomerular pressure, decreases proteinuria, and slows the progression of diabetic nephropathy, on top of lowering blood pressure. Because of this renal-protective effect, ACE inhibitors are the preferred choice when kidney protection is a priority in diabetic hypertension. If ACE inhibitors aren’t tolerated, ARBs offer a similar renoprotective benefit.

Thiazide diuretics primarily lower blood pressure and help with volume management but don’t provide the same specific kidney-protective effects as ACE inhibitors. Calcium channel blockers and beta blockers are effective antihypertensives but do not offer the same renal protection in diabetes.