A patient with hypertension and sinus node dysfunction should be treated with an antihypertensive agent that has which of the following properties?

• A. Sympatholytic
• B. Diuretic
• C. Sympathomimetic
• D. Vasodilation

Answer: (C)

When hypertension coexists with sinus node dysfunction, the heart’s natural pacing can be unreliable and be worsened by drugs that slow the heart rate. The best choice among these options is one that stimulates the sympathetic system, increasing heart rate and improving automaticity of the sinus node, while still providing blood pressure reduction through vascular effects. A sympathomimetic directly enhances cardiac chronotropy and can help maintain adequate cardiac output in the setting of bradyarrhythmia, which is why it fits this scenario best.

Avoiding a sympatholytic is important here because it would further blunt heart rate and conduction. A diuretic lowers blood pressure mainly by reducing volume without addressing heart-rate support, and vasodilation can trigger reflex changes that don’t specifically counteract sinus node dysfunction.