Essential Hypertension Has Been in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#295

SMLE Question #295

Medicine / Internal Medicine Cardiology
Last updated: February 2026
A 58-year-old man with essential hypertension has been well controlled for 6 months on captopril. For 3 weeks, he has had a persistent, nonproductive cough that is worse at night and disrupts sleep. He denies fever, sputum, wheeze, or recent upper respiratory symptoms. Chest examination is normal, and a chest X-ray is unremarkable. He requests a medication change. Which antihypertensive is the most appropriate to start?

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