The stepped-care approach to the treatment of hypertension includes

The correct answer is C because the stepped-care approach to treating hypertension involves starting with lifestyle modifications (A) like exercise, diet changes, and reducing smoking/alcohol intake. If blood pressure is not adequately controlled with lifestyle changes alone, then medication like diuretics, beta-blockers, or ACE inhibitors (B) can be added. Therefore, "all of the above" (C) is correct as it encompasses both lifestyle modifications and medication use in a stepwise manner. Choice D is incorrect because using a combination of antihypertensive drug classes is not always the initial step in the stepped-care approach; it is usually reserved for cases where single-drug therapy is not sufficient.