Final answer:
Mason, who has diabetes and is overweight, should have his hypertension treated aggressively, preferably with ACE inhibitors. Lifestyle changes should also be part of the treatment plan but should not delay the initiation of pharmacological therapy. Each patient's treatment must be personalized, taking into account the complexity of their condition.
Step-by-step explanation:
To properly treat hypertension in a patient like Mason who has diabetes mellitus (DM) and is overweight, option c is generally the recommended approach. It is important to treat hypertension aggressively, especially in DM patients, to reduce the risk of cardiovascular complications. Angiotensin-converting enzyme (ACE) inhibitors are often the preferred initial therapy because they not only lower blood pressure but also offer additional protection for the kidneys, which can be affected by diabetes.
However, treating hypertension in a diabetic patient requires a comprehensive approach including lifestyle modifications such as exercise, weight loss, and a healthy diet, as well as careful monitoring and potential combination therapy due to the complexity of the disease interactions. Physicians may also consider other antihypertensive medications such as calcium channel blockers, thiazide diuretics, or angiotensin receptor blockers (ARBs) depending on the individual patient's circumstances and comorbidities.
Each case must be assessed on an individual basis, and while Mason may certainly benefit from lifestyle changes, it is essential to start antihypertensive therapy alongside those changes, rather than delaying pharmacological treatment until after lifestyle interventions have been attempted. Therefore, option b is not ideal, as it suggests delaying medication which could increase complication risks, and option d is also not advisable as it waits for a higher threshold to start treatment, potentially placing the patient at greater risk.