A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?

According to the International Society of Hypertension, lifestyle interventions are recommended for three to six months before medication in patients with grade 1 hypertension (BP < 160/100 mm Hg) and no comorbidities.Diet and exercise can lower BP by reducing weight, sodium intake, alcohol consumption, and stress levels.

Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors are not the first-line medication for hypertension in the general population.They are preferred in patients with diabetes, chronic kidney disease, or heart failure.

Choice B is wrong because combination diuretics are not the initial recommendation for hypertension.They are used when monotherapy is not sufficient to achieve the target BP or when there is fluid retention.

Choice C is wrong because beta-adrenergic blocking agents are not the first-line medication for hypertension in the general population.They are preferred in patients with ischemic heart disease, heart failure, or arrhythmias.

This is because digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and require dose adjustment or discontinuation of the medication.Digoxin helps make the heart beat stronger and with a more regular rhythm by inhibiting sodium-potassium ATPase in cardiac cells.It is used to treat heart failure and atrial fibrillation.

Choice A is wrong because increasing sodium intake can worsen fluid retention and exacerbate heart failure symptoms.Patients with heart failure should follow a low-sodium diet to reduce the workload on the heart.

Choice B is wrong because checking pulse rate for 30 seconds and multiplying result by 2 is not accurate enough to monitor the effects of digoxin.

Patients taking digoxin should check their pulse rate for one full minute before taking each dose and record it daily.If the pulse rate is too fast or too slow, they should contact their provider.

Choice C is wrong because taking digoxin with food may reduce its absorption and effectiveness.Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal.If nausea occurs, it may be a sign of digoxin toxicity and should be reported to the provider.