Which class of antihypertensive medications is least likely to be effective for a 61-year-old Black man with chronic hypertension?

Choice A reason: CCBs are effective in Black patients with hypertension, especially in monotherapy. They work by relaxing vascular smooth muscle and reducing peripheral resistance, which is beneficial in salt-sensitive hypertension. Choice B reason: ACE inhibitors are less effective as monotherapy in Black patients due to lower plasma renin activity. They may be used in combination therapy but are not preferred as initial treatment unless there are compelling indications such as heart failure or diabetic nephropathy. Choice C reason: ARBs have similar limitations to ACE inhibitors in Black populations but may be better tolerated due to lower risk of cough. They are more effective when combined with diuretics or CCBs. Choice D reason: Beta blockers are generally less effective in controlling blood pressure in Black patients unless there are specific indications such as arrhythmias or post-MI management. However, ACE inhibitors are still considered less effective overall in this demographic.