Some of these drugs frankly just wouldn't be used in a person who's coming in with only a history of hypertension, who hasn't been tried on any other meds. Basically, the idea here is that by controlling blood pressure, you're reducing the risk of MI. Hypertension ultimately leads to left ventricular hypertrophy, and potentially MI and heart failure, so lowering it can help prevent or decrease the likelihood of these outcomes. But other risk factors are important as well, such as family history, smoking history, lipid levels, etc. While technically a number of these drugs would decrease this gentleman's pressure, that doesn't necessarily mean they're generally used in the type of setting you described. So perhaps the best way to answer this question, although it may seem a bit roundabout, would be to quickly run through what my clinical reasoning might be in this situation.
Depending on how high his pressure actually is (stage I, stage II, etc.) you'd likely start off with just a thiazide diuretic like hydrochlorothiazide, which is very inexpensive and effective. If it's over 160/100, you'd likely need to start with two agents to sufficiently lower his BP. As I stated above, by lowering his BP you thereby decrease his cardiovascular risk, of stroke and heart attack. Thiazides are thought to be particularly effective in African Americans, but are somewhat contraindicated in anyone who has gout, as they tend to increase the uric acid level in the blood. Overall though, they're great, cheap drugs! So unless you have a specific reason NOT to use HCTZ, you'd start with this medication in this clinical setting.
You almost definitely would NOT use spironolactone here...it often causes men to develop breasts, and it just isn't a first line agent in hypertension. It's more often used in liver disease. And you wouldn't start off with clonidine either, which is a really potent agent often used in malignant hypertension in emergency settings. It causes rebound hypertension when you stop taking it, and is not a commonly used drug in the clinical setting.
Other common antihypertensive choices include beta blockers and ACE inhibitors (you have ramapril listed here). These medications are well known to reduce cardiovascular mortality AFTER a heart attack (so-called "secondary prevention"), and they're good blood pressure lowering medications too. Beta blockers would likely be tried prior to ACE inhibitors, as they're older and there's more data, but if the thiazide lowered his BP enough you wouldn't need to add a beta blocker. Commonly used examples are atenolol and metoprolol. Of course, you have to watch his pulse...if it's 40 or 50, you probably wouldn't give a beta blocker, which will likely slow it even more. Also, beta blockers can precipitate depression, and cause impotence, so you have to be aware of side effects. If you needed to add a second agent here but you couldn't use a beta blocker, you'd likely use an ACE inhibitor. They're generally well tolerated, although the occasional person will develop an annoying cough from the buildup of bradykinin, or develop potentially life-threatening angioedema. You also need to watch their potassium, as ACE inhibitors can cause hyperkalemia, which can cause fatal arrhythmias.
You mentioned nifedipine. This generally wouldn't be a first line agent in controlling hypertension either, although you might use it as a second agent in certain settings. There's a whole range of calcium channel blockers, the class which nifedipine belongs to, and some are more useful for hypertension, like amlodipine (Norvasc), while others are more useful for arrhythmias and angina, like diltiazem. But as I said, you'd try HCTZ, and then a beta blocker or ACE inhibitor, before you'd use a CCB.
Almost anyone who's 62 should be taking aspirin 81mg daily, which slightly "thins" the blood, thereby decreasing the risk of heart attack. Most heart attacks develop when a coronary atherosclerotic plaque ruptures, exposing endothelium and thereby activating the clotting cascade, fostering the development of an occlusive thrombus. So by taking aspirin daily, you help decrease the risk of developing such a thrombus, since by irreversibly inhibiting the cyclooxygenase enzyme you decrease the production of thromboxane A2, thereby decreasing platelet aggregation, which is the first step in clot formation. That's my understanding of the rationale for daily ASA use in primary prevention of an MI.
Vitamin E is controversial, but there have been a few large trials done recently that seem to demonstrate that it does NOT have cardioprotective effects.
HMG CoA inhibitors (statins) like pravastatin are obviously used in people with high cholesterol. Since you didn't mention that this guy has hyperlipidemia, you wouldn't just give him a statin, as they're not entirely benign drugs (they can cause lethal rhabdomyolysis, hepatic injury, etc.). But as a 62 year old, he probably does have elevated cholesterol, so after getting a fasting lipid panel and finding that his LDL is 150 or something like that, you'd likely initiate statin therapy. You're might first try dietary and lifestyle changes for a few months, if this is a new diagnosis, and then if that fails you'd try a statin. Interestingly, fiber therapy, such as with Metamucil, also helps lower one's cholesterol. If you start a statin, you want to aim for an LDL of <100. Although, some recent data from JAMA and elsewhere suggests that a more appropriate target would be around 70. You also want to look at their HDL, as higher HDL is actually cardio-PROTECTIVE. Niacin, while often poorly tolerated due to its causing cutaneous flushing for the first few weeks/months, can help increase HDL.
Whew...that's a lot! I hope that's helpful. Sometimes it's not easy to just say "x is cardioprotective" and y is not. Much of this depends on the clinical scenario, whether we're talking about primary or secondary prevention, what a person's co-morbidities are, etc. Does that make sense?
