A 58-year-old hypertensive patient with bilateral renal artery stenosis is being considered for antihypertensive therapy. Which of the following drug classes is CONTRAINDICATED in this patient?

• A Calcium channel blockers
• B Beta blockers
• C Alpha-1 blockers
• D ACE inhibitors ✓

Explanation

ACE inhibitors block angiotensin II-mediated efferent arteriolar constriction, which is the primary mechanism maintaining GFR when afferent flow is compromised. In bilateral renal artery stenosis, both kidneys depend on this efferent vasoconstriction; blocking it precipitates acute renal failure. ARBs carry the same contraindication for the same mechanism.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.