What is the initial treatment recommended for an elderly patient with hypertension and diabetes?

The recommended initial treatment for an elderly patient with hypertension and diabetes is ACE inhibitors. This is primarily due to their specific benefits in this population. ACE inhibitors help to lower blood pressure and have a protective effect on the kidneys, which is particularly important for patients with diabetes. The renal protective effect is due to their ability to reduce intraglomerular pressure, thus slowing the progression of diabetic nephropathy.

Additionally, ACE inhibitors have been shown to reduce cardiovascular morbidity and mortality in patients with diabetes, making them a favorable choice for this group. The initiation of treatment with ACE inhibitors is also supported by guidelines that emphasize their efficacy and safety in managing both hypertension and comorbid conditions like diabetes in the elderly population.

While diuretics, calcium channel blockers, and beta-blockers can also be effective in managing hypertension, they do not offer the same level of renal protection that ACE inhibitors provide. Thus, for an elderly patient with both hypertension and diabetes, ACE inhibitors are considered the most appropriate first-line therapy.