Which antihypertensive medication increases mortality when used to treat chronic hypertension?

• A. Long-acting beta blockers
• B. Angiotensin receptor blockers
• C. Potassium-sparing diuretics
• D. Short-acting calcium channel blockers

Answer: (D)

Short-acting calcium channel blockers are associated with higher mortality when used for chronic hypertension. The rapid onset of vasodilation from these drugs can trigger reflex sympathetic activation and tachycardia, leading to increased myocardial oxygen demand and potential adverse events such as ischemia or stroke in susceptible patients. This pattern contrasts with long-acting calcium channel blockers, which provide steady BP control without those harmful peaks. Other classes listed generally reduce mortality or are neutral in chronic hypertension, making the short-acting calcium channel blocker the one linked to worse outcomes in this setting.