Popular Cardiologist in Rajanukunte, Bangalore • Coexisting disease and patient risk profile LVH: Choose ACE inhibitors, ARAs, alpha-blockers, beta-blockers, calcium antagonists. Previous acute myocardial infarction (AMI): Choose beta-blockers, ACE inhibitors in left ventricular dysfunction (LVD). Angina: Choose beta-blockers, verapamil, diltiazem. Cardiac failure or LVD: ACE inhibitors (and ARAs) and beta-blockers (carvedilol, bisoprolol and slow-release metoprolol) reduce symptoms and mortality. Monoxi-­ dine is contraindicated. Diuretics reduce symptoms, but loop diuretics (frusemide) are too short-acting to be useful for hypertension. Diabetes: ACE inhibitors and ARAs protect renal function in patients with pro-­ teinuria.16 Aortic stenosis: Vasodilators should be used with caution. Renovascular disease: ACE inhibitors and ARAs are effective but can lead to deterioration of renal function. Potassium and creatinine levels should be monitored. ACE inhibitors and ARAs are contraindicated in bilateral renal artery stenosis, or where there is a single functioning kidney. PVD: Beta-blockers are relatively contraindicated. Stroke: ARAs and low-dose thiazides are more effective for prevention than beta-blockers. Diabetes: Diuretics have an adverse effect on glucose metabolism. ACE inhibitors and ARAs are of value in reducing the development of diabetic nephropathy. Dyslipidaemia: Alpha-blockers have a mild beneficial effect on serum lipids. ACE inhibi-­ tors and calcium antagonists have a neutral effect. Gout: Diuretics inhibit uric acid excretion and are relatively contraindicated. Asthma and chronic obstructive pulmonary disease (COPD): Beta-blockers are usually contraindicated. Depression: Methyldopa, calcium antagonists and clonidine may aggravate.