Which class of medications is indicated as a first-line treatment for patients with compelling indications such as diabetes?

ACE inhibitors are considered a first-line treatment for patients with hypertension who have compelling indications such as diabetes. This is due to their ability to provide renal protective effects and reduce the risk of cardiovascular complications.

In patients with diabetes, controlling blood pressure is crucial because they are at a higher risk of developing diabetic nephropathy and other cardiovascular issues. ACE inhibitors can help manage blood pressure while also offering additional benefits, such as reducing albuminuria, which is significant for maintaining kidney health in diabetic patients.

The other classes, while used for hypertension, do not have the same level of evidence supporting their use specifically for diabetes-related complications. For example, while beta-blockers can be beneficial for certain patients, they do not provide the renal protective benefits seen with ACE inhibitors. Similarly, calcium channel blockers and ARBs do not have the same renal advantages for diabetic patients as ACE inhibitors do.