What symptom is most significant for a male patient taking propranolol for hypertension?

Propranolol is a non-selective beta-blocker commonly used for managing hypertension as well as other cardiovascular conditions. One potential side effect of propranolol, particularly in sensitive individuals or those with underlying respiratory conditions, is bronchospasm. This manifests clinically as expiratory wheezes. This is significant for a male patient taking propranolol because wheezing may indicate bronchial constriction, which could be alarming, especially if the patient has a history of asthma or chronic obstructive pulmonary disease (COPD).

The presence of expiratory wheezes suggests that the patient may be experiencing respiratory side effects due to the medication. Given that propranolol blocks beta-2 adrenergic receptors in addition to beta-1 receptors, this can lead to narrowed airways and exacerbation of breathing difficulties. Therefore, the identification and management of wheezing in a patient on propranolol are critical, as it can lead to serious complications if not addressed.

In contrast, other symptoms mentioned—blood pressure, glomerular filtration rate, and hemoglobin A1c—may provide valuable clinical information but do not directly indicate an acute, significant side effect of propranolol in the context of respiratory function. Thus, wheezing is the most