<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 61-year-old woman presents to her primary care provider with complaints of fatigue, weight gain of 5.5 kg 12.1 lb and intermittent nausea over the past 4 months. She denies any changes to her diet. She has had type 2 diabetes mellitus for the past 27 years complicated by diabetic neuropathy. Vital signs include: temperature 37.0C 98.6F, blood pressure 16798 mm Hg and pulse 80min. Physical examination reveals bilateral pitting lower-extremity edema. Fundoscopic examination reveals bilateral micro-aneurysms and cotton wool patches. Her serum creatinine is 2.6 mgdL. Which of the following is the best initial therapy for this patient?? A: Hydrochlorothiazide, B: Perindopril, C: Metoprolol, D: Diltiazem, E: Labetalol,  <response>: This is a patient with longstanding type 2 diabetes mellitus who now presents with symptoms and signs of diabetic nephropathy, including fatigue, weight gain, nausea, hypertension, pitting edema, diabetic retinopathy, and an elevated serum creatinine. The goal of therapy is to control her blood pressure to slow the progression of kidney disease. Choice A, a thiazide diuretic, is not optimal as it can worsen renal function in patients with impaired kidney function. Choice B, an ACE inhibitor, is the best initial therapy as it is both renoprotective and lowers blood pressure.Choice C, a beta blocker, D, a calcium channel blocker, and E, an alphabeta blocker, are antihypertensives but do not offer renoprotection.B: Perindopril 