Some hypertension treatment guidelines published in the late 1990's recommended that diuretics and betha-blockers be used as 1st line drugs for treating uncomplicated hypertension, reserving new antihypertensive drugs for special indications.
Which antihypertensive drugs are used to treat hypertension (high blood pressure)?
There is general agreement as to which antihypertensive drugs are appropriate for initial therapy in most patients with hypertension. The major options are: ● Angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs)
What are the treatment options for hypertension without compelling indications?
Choice of therapy for adults with hypertension without compelling indications for specific agents Initial therapy should be with either monotherapy or SPC. a thiazide/thiazide-like diuretic (Grade A), with longer-acting diuretics preferred (Grade B); a long-acting CCB (Grade B).
When are beta-blockers not recommended as first-line therapy for uncomplicated hypertension?
α-blockers are not recommended as first-line agents for uncomplicated hypertension (Grade A); β-blockers are not recommended as first-line therapy for uncomplicated hypertension in patients 60 years of age or older (Grade A); and ACE inhibitors are not recommended as first-line therapy for uncomplicated hypertension in black patients (Grade A).
What is not recommended as a first-line treatment for hypertension (high blood pressure)?
a-Blockers are not recommended as first-line agents for un-complicated hypertension (Grade A); b-blockers are not recommended as first-line therapy for uncomplicated hy-pertension in patients 60 years of age or older (Grade A); and ACE inhibitors are not recommended as first-line therapy for uncomplicated hypertension in black patients (Grade A).
What drug class is recommended as the initial treatment for hypertension?
There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.
What is the initial treatment for uncomplicated hypertension?
However, for most patients with uncomplicated hypertension low-dose thiazide-type diuretics should be first-line therapy. The choice of add-on therapy, which may be required later in up to two-thirds of patients, is not as clearly defined. Beta blocking drugs and ACE inhibitors are effective when used with a diuretic.
What are the first line drugs used when a patient is diagnosed with hypertension?
Treatment was to be clearly defined as a specific class of first‐line antihypertensive therapy in one of the following classes: thiazide diuretics, beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, or alpha adrenergic blockers.
Which class of drug are useful in treatment of hypertension?
There are multiple classes of antihypertensive medications used for the treatment of HTN; the most recommended classes used as first-line for treatment are: Thiazide-type diuretics. Calcium channel blockers. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)
What is uncomplicated hypertension?
Among these visits, those without any of the following compelling indications were defined as having uncomplicated hypertension: hypertensive organ damage, ischemic heart disease, diabetes mellitus, heart failure, cerebrovascular disease, and chronic renal disease.
What is the best drug for newly diagnosed hypertension?
Low-dose thiazide diuretics (eg, hydrochlorothiazide 12.5 to 25 mg/d) are the best first-line pharmacotherapy for treating uncomplicated hypertension (strength of recommendation [SOR]: A, based on randomized trials [RCTs] and 1 meta-analysis).
Why are ACE inhibitors first-line in hypertension?
Introduction. ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers (ARBs) effectively lower blood pressure (BP) through inhibition of the renin-angiotensin system and are equally recommended as first-line medications in the treatment of hypertension.
Methods
Our hypothesis was that use of a simplified algorithm for the treatment of hypertension would result in better practice-level blood pressure control than conventional guideline-based care. The goal was to determine the effectiveness of the treatment algorithm within the family practice setting.
Results
A total of 45 practices were successful in identifying ≥50 patients with uncontrolled hypertension and enrolling ≥30 patients with confirmed uncontrolled hypertension. Of these, 18 practices had been assigned to STITCH care and 27 had been assigned to guideline care.
Discussion
Identification of new strategies for improving blood pressure control in a family practice setting is a healthcare priority.
Footnotes
Correspondence to Ross D. Feldman, Robarts Research Institute, 100 Perth Dr, London, Ontario N6A 5K8, Canada. E-mail [email protected]
What antihypertensive drugs should be used if target BP levels are not achieved with standard-dose
Additional antihypertensive drugs should be used if target BP levels are not achieved with standard-dose monotherapy (Grade B). Add-on drugs should be chosen from first-line choices. Useful choices include a thiazide/thiazide-like diuretic or CCB with either: ACE inhibitor, ARB, or b-blocker ...
Is sodium glucose cotransporter 2 a SGLT2 inhibitor?
This topic has been reviewed and discussed by the HCGC at our 2017 and 2019 consensus conferences and a formal recommendation has not been developed for the use of sodium-glucose co-transporter-2 (SGLT2) inhibitors in the management of persons with comorbid diabetes and hypertension. However, the rationale for reviewing this topic is summarized herein. SGLT2s have been shown to improve survival and improve clinical outcomes in persons with type 2 diabetes, diabetes and heart failure, and diabetes-related kidney disease (GFR 30-60 mL/min/m2).Benefits on heart outcomes (namely reduced hospitalizations for heart failure) have been recently reported in the Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction (DAPA-HF) trial, which enrolled 4744 patients with HFrEF, 58% of which did NOT have type 2 diabetes.
Is a blocker a first line therapy?
a-Blockers are not recommended as first-line agents for uncomplicated isolated systolic hypertension (Grade A); and b-blockers are not recommended as first-line therapy for isolated systolic hypertension in patients aged 60 years or older (Grade A). However, both agents may be used in patients with certain comorbid conditions or in combination ...