What is included in the first-line therapeutic approach to lowering blood pressure in a patient diagnosed with essential hypertension? (Select all that apply)

Choice A rationale
Stable angina is characterized by chest pain that occurs with exertion and is relieved by rest. If a patient with angina pectoris is experiencing chest pain at rest and needs to take three nitroglycerin pills to relieve the pain, this is not typical of stable angina.
Choice B rationale
A full-blown acute myocardial infarction (MI), or heart attack, typically presents with severe chest pain, shortness of breath, and other symptoms. While chest pain at rest could be a symptom of an MI, other symptoms would likely be present.
Choice C rationale
Unstable angina is characterized by chest pain that occurs at rest, is severe and prolonged, and is not relieved by nitroglycerin. Therefore, a patient with angina pectoris who is experiencing chest pain at rest and needs to take three nitroglycerin pills to relieve the pain could be experiencing unstable angina.
Choice D rationale
Pulmonary embolus, a blockage in one of the pulmonary arteries in the lungs, typically presents with sudden-onset shortness of breath, chest pain that may become worse upon deep breathing or coughing, and other symptoms. Chest pain at rest could be a symptom of a pulmonary embolus, but other symptoms would likely be present.

Choice A rationale: Adenosine Adenosine is a naturally occurring substance that relaxes and dilates blood vessels. It also affects the electrical activity of the heart. Adenosine is used to help restore normal heartbeats in people with certain heart rhythm disorders. However, it is not typically used for atrial fibrillation.

Choice B rationale: Diltiazem Diltiazem belongs to a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. Diltiazem also increases the supply of blood and oxygen to the heart. It is used in adults alone or in combination with other medications to treat hypertension (high blood pressure) or symptoms of angina (chest pain). Diltiazem injection is used in adults to treat certain heart rhythm disorders such as atrial fibrillation.

Choice C rationale: Atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. However, it is not typically used for atrial fibrillation.

Choice D rationale: Captopril Captopril is used in adults alone or in combination with other medications to treat high blood pressure (hypertension) and congestive heart failure.
Captopril is also used to improve survival and reduce the risk of heart failure after a heart attack in patients with a heart condition called left ventricular hypertrophy (enlargement of the walls of the left side of the heart)4. However, it is not typically used for atrial fibrillation.