Which antihypertensive is recommended for a diabetic patient with proteinuria?

In diabetic patients, particularly those with proteinuria, ACE inhibitors are recommended due to their renal protective effects. They not only help in managing hypertension but also have specific benefits in reducing the progression of diabetic nephropathy. The mechanism involves the blockage of the renin-angiotensin-aldosterone system, which helps decrease intraglomerular pressure and, consequently, the amount of protein that leaks into the urine. This protective mechanism is vital as proteinuria is a marker of kidney damage and can lead to worsening renal function over time.

While other antihypertensive classes, like beta-blockers, calcium channel blockers, and thiazide diuretics, may be effective in lowering blood pressure, they do not offer the same level of renal protection for patients with diabetes and proteinuria. Hence, ACE inhibitors are prioritized in these cases, aligning with clinical guidelines for managing hypertension in diabetic patients with evidence of renal involvement.