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Hypertension and Dyslipidemia Therapy Flashcards

7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which fibrate carries the lowest risk of myopathy when used in combination with a statin?

    Answer: Fenofibrate

    Fenofibrate does not inhibit glucuronidation of statins (unlike gemfibrozil) and therefore carries a significantly lower risk of statin-associated myopathy.

  2. A patient on lisinopril develops a dry cough. The pharmacist recommends switching to which medication?

    Answer: Losartan

    ACE inhibitor–induced cough (due to bradykinin accumulation) is a class effect; ARBs such as losartan do not affect bradykinin and are the preferred switch.

  3. What is the primary mechanism by which spironolactone lowers blood pressure in resistant hypertension?

    Answer: Aldosterone receptor antagonism promoting sodium excretion

    Spironolactone blocks mineralocorticoid receptors, preventing aldosterone-mediated sodium and water retention, which is particularly effective in patients with elevated aldosterone levels.

  4. Colesevelam (a bile acid sequestrant) is unique among lipid-lowering agents because it also reduces which other cardiovascular risk marker?

    Answer: Hemoglobin A1c in type 2 diabetes

    Colesevelam has FDA approval for improving glycemic control in type 2 diabetes, making it a dual-benefit agent in diabetic patients with dyslipidemia.

  5. A patient with hypertension and a history of angioedema on enalapril is started on sacubitril/valsartan for HFrEF. What important counseling point applies?

    Answer: Sacubitril/valsartan is contraindicated in patients with prior ACE inhibitor angioedema

    A history of ACE inhibitor–induced angioedema is a contraindication to sacubitril/valsartan because neprilysin inhibition further raises bradykinin levels, increasing angioedema risk.

  6. Which of the following best describes the mechanism of action of bempedoic acid?

    Answer: Inhibits ATP-citrate lyase upstream of HMG-CoA reductase

    Bempedoic acid inhibits ATP-citrate lyase, a step upstream of HMG-CoA reductase in the hepatic cholesterol synthesis pathway, and is a prodrug activated only in the liver.

  7. An African American patient with hypertension has a BP of 148/92 mmHg. Which initial therapy is preferred based on clinical trial data and guidelines?

    Answer: Thiazide diuretic or calcium channel blocker

    Clinical trials (ALLHAT) show thiazide diuretics and calcium channel blockers are more effective antihypertensives in African American patients compared to ACE inhibitors or ARBs as monotherapy.