According to the JNC VII guidelines, which antihypertensive agent is preferred for a young patient with type 1 diabetes mellitus?

• A. Beta-blocker.
• B. Loop diuretic.
• C. ACE inhibitor.
• D. Thiazide diuretic.

Answer: (C)

ACE inhibitors are preferred in young patients with type 1 diabetes and hypertension because they protect kidney function and reduce albuminuria, which helps slow the progression of diabetic nephropathy. They also provide cardiovascular benefits and are generally well tolerated in this population. This makes them the first-line choice when diabetes is present and hypertension needs management, per JNC VII guidance.

Beta-blockers can mask hypoglycemia symptoms and may have less favorable effects on lipid and glucose metabolism, which is problematic in type 1 diabetes. Loop diuretics are effective for volume control but don’t offer the same renal-protective benefits for diabetes. Thiazide diuretics can worsen glucose tolerance and have adverse metabolic effects, though they are used in hypertension, they are not the preferred initial choice in a young patient with type 1 diabetes.