The stepped-care approach to the treatment of hypertension includes

A) Take this medication with food:
Captopril is an ACE inhibitor, known to work best on an empty stomach. Food can reduce its absorption, impacting its effectiveness. Thus, while clients can take captopril with or without food, it's generally recommended to take it on an empty stomach for optimal results.

B) Monitor for a cough:
Captopril, an ACE inhibitor, commonly induces a persistent, dry cough due to the accumulation of bradykinin. This side effect can be bothersome and may necessitate discontinuation of the medication. Therefore, patients should be vigilant for the onset of a cough and promptly report it to their healthcare provider.

C) Avoid bananas:
Although captopril can occasionally lead to hyperkalemia, advising patients to avoid bananas specifically may not be necessary. While bananas are potassium-rich, restricting them alone might not significantly impact potassium levels. However, patients should be educated on monitoring potassium intake and informed of potential dietary modifications if hyperkalemia occurs.

D) Hold medication for heart rate less than 100/min:
Captopril is not known to directly affect heart rate. This instruction may be more applicable to medications like beta-blockers, which can lower heart rate as part of their mechanism of action. Therefore, holding captopril for heart rates below 100/min may not be clinically indicated.

A) Obstructive sleep apnea (OSA):
Obstructive sleep apnea is a known risk factor for the development of hypertension. During episodes of sleep apnea, breathing repeatedly stops and starts, leading to disruptions in normal sleep patterns and potentially contributing to increased sympathetic nervous system activity, systemic inflammation, and endothelial dysfunction, all of which can elevate blood pressure over time.

B) The choice B was incorrect. While a diet high in potassium is generally associated with lower blood pressure due to its beneficial effects on blood vessel function and fluid balance, it is not considered a risk factor for developing hypertension. In fact, potassium-rich foods like fruits, vegetables, and legumes are often recommended as part of a heart-healthy diet to help manage blood pressure.

C) The choice C was incorrect. A high-density lipoprotein (HDL) level of 70 mg/dL is actually considered beneficial for cardiovascular health. HDL is often referred to as "good" cholesterol because it helps remove LDL (low-density lipoprotein) cholesterol from the bloodstream, reducing the risk of plaque buildup in the arteries. Having a high HDL level is typically associated with a lower risk of cardiovascular disease, including hypertension.

D) The choice D was incorrect. Benazepril is actually an antihypertensive medication, specifically an angiotensin-converting enzyme (ACE) inhibitor. It is used to treat hypertension, not as a risk factor for its development. ACE inhibitors work by relaxing blood vessels, which helps lower blood pressure. While taking certain medications like benazepril may contribute to the management of hypertension, they are not considered risk factors for its development.

E) Cigarette smoking:
Cigarette smoking is a well-established risk factor for the development of hypertension. Smoking cigarettes can lead to the constriction of blood vessels, increased heart rate, and damage to the lining of blood vessels, all of which can elevate blood pressure. Additionally, the chemicals in tobacco smoke can contribute to inflammation and oxidative stress, further exacerbating cardiovascular risk factors. Smoking cessation is an essential component of hypertension management and overall cardiovascular health.