Mayoclinic.org
Apr 18, 2018 · Treatment: First‐line ‐ chlorothiazide 500 mg Second‐line ‐ dose increased to 1000 mg, or addition of Methyldopa, propranolol, or pindolol Third‐line drugs added were hydralazine or clonidine Control: placebo: Outcomes
Top10homeremedies.com
A total of 79 288 patients fulfilled the criteria for first-line therapy and adherence (17.4% diuretics, 25.9% beta blockers, 45.1% inhibitors of the renin-angiotensin system, and 11.6% calcium channel blockers). Differences in demography and comorbidities were consistent with expectations based on treatment guidelines.
Medicalnewstoday.com
Oct 25, 2019 · More specifically, in this analysis, physicians prescribed ACE inhibitors 48% of the time, while doctors prescribed thiazide diuretics as …
What are the first line medications for hypertension?
First-line low-dose thiazides reduced all morbidity and mortality outcomes in adult patients with moderate to severe primary hypertension. First-line ACE inhibitors and calcium channel blockers may be similarly effective, but the evidence was of lower quality.
What is the first line drug for hypertension?
Apr 01, 2005 · 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 JNC stages of hypertension?
Nov 18, 2020 · NICE guidelines recommend ACEI/ARB as the first line treatment for hypertension for those younger than 55.2 This age threshold, currently absent in international guidelines, is based on the idea that hypertension in younger people is more commonly characterised by high renin levels.7 8 The age cut-off point in NICE guidelines is supported by studies limited by …
What is the first line of blood pressure medication?
May 07, 2018 · Initial first-line therapy for stage 1 hypertension includes thiazide diuretics, CCBs, and ACE inhibitors or ARBs. Two first-line drugs of different classes are recommended with stage 2 hypertension and average BP of 20/10 mm Hg above the BP target.
What is the first drug of choice for hypertension?
The strongest body of evidence indicates that for most patients with hypertension, thiazide diuretics are the best proven first-line treatment in reducing morbidity and mortality.Jun 1, 2010
What is the first step in the treatment of hypertension?
Diuretics are the first step in the treatment of most patients with hypertension and the new clinical trials should focus on drugs to be added to them as the second step in the management of hypertension.Sep 25, 2001
What is the best treatment for high blood pressure?
AdvertisementLose extra pounds and watch your waistline. Blood pressure often increases as weight increases. ... Exercise regularly. ... Eat a healthy diet. ... Reduce sodium in your diet. ... Limit the amount of alcohol you drink. ... Quit smoking. ... Cut back on caffeine. ... Reduce your stress.More items...
Which drug is given during hypertension?
Equanil is an important tranquillizer used in depression and hypertension. Was this answer helpful?
How many side effects does ACE inhibitor have?
Furthermore, ACE inhibitors caused higher rates of 19 side effects, compared with other first-line treatments. Also, non-dihydropyridine calcium channel blockers were the least effective first-line treatment that the study authors identified. Finally, the authors estimate that 3,100 adverse cardiovascular events could have been prevented if ...
Which organization has based their guidelines on randomized clinical trials?
First, the existing literature that organizations such as the American College of Cardiology and the American Heart Association (AHA) have based their guidelines on are randomized clinical trials with an insufficient number of participants, very few of whom are just beginning their treatment, explain Dr. Suchard and colleagues.
Which first line drug has more side effects than thiazide?
The study revealed that angiotensin converting enzyme (ACE) inhibitors, which are the most commonly prescribed first-line drugs, had more side effects than thiazide diuretics, a class of drugs that are not prescribed as often.
Who is the first author of the paper "The First Line of Treatment for Hypertension"?
A new paper — the first author of which is Dr. Marc A. Suchard, from the department of biostatistics at the University of California, Los Angeles — showcases some of the pitfalls behind deciding which is the best first line of treatment for hypertension.
Can beta blockers be used for hypertension?
Current evidence does not support the use of beta blockers, particularly atenolol, as first-line treatment for hypertension. Although there is increasing evidence that ACE inhibitors and possibly CCBs may be equivalent to thiazide diuretics in reducing morbidity and mortality, the relative expense of these medications makes thiazide diuretics ...
Is thiazide a beta blocker?
Current evidence does not support using beta blockers as first-line therapy for hypertension.
Do beta blockers reduce the risk of CHD?
Beta blockers did not show any ARR of cardiovascular events for secondary or primary prevention in patients with moderate to severe hypertension. 1. Thiazide diuretics and ACE inhibitors significantly reduced the risk of CHD, whereas beta blockers (risk ratio [RR] = 0.90; 95% confidence interval [CI], 0.86 to 1.07) and CCBs (RR = 0.77; 95% CI, ...
Is thiazide a first line treatment?
The strongest body of evidence indicates that for most patients with hypertension, thiazide diuretics are the best proven first-line treatment in reducing morbidity and mortality. They are particularly effective in the secondary prevention of cardiovascular events in all patients with hypertension, and in the primary prevention ...
Why do people with essential hypertension stop taking calcium channel blockers?
Patients with essential hypertension taking calcium channel blockers stop their medication because of adverse effects more frequently than those patients taking diuretics. 2. Thiazide diuretics are no longer first-line treatment for uncomplicated hypertension.
What is the goal of uncomplicated hypertension?
Summary. The goal of therapy in uncomplicated hypertension is to reduce cardiovascular risk by lowering the patient's blood pressure. If non-drug treatment is ineffective, the choice of drug treatment is determined by its safety and efficacy. When safety and efficacy are equal the lowest cost drug should be prescribed.
Is thiazide diuretic high risk for diabetes?
Patients with hypertension are often overweight and have an increased likelihood of developing diabetes, independent of treatment. The small extra risk of type 2 diabetes with the long-term use of thiazide diuretics was reported in the 1960s when relatively high doses were used.
What percentage of the population is affected by PBS?
In a Pharmaceutical Benefits Scheme (PBS) which is continually under threat, small differences in cost (to the taxpayer) in treating a condition which affects 10-15% of the population can add up to substantial sums, particularly as treatment is usually lifelong.
What is the World Health Organization's guide to good prescribing?
The World Health Organization program, the 'Guide to good prescribing', emphasises comparative safety, convenience and cost as well as efficacy as important discriminators in making choices. 6.
Is thiazide a first line diuretic?
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.
Is hypertension a family history?
These patients commonly have a family history of hypertension, but clinical assessment and selective investigation reveal no primary underlying cause of the hypertension.
How does high blood pressure affect the world?
High blood pressure, or hypertension, affects more than one in four adults globally and is a major modifiable risk factor for morbidity and mortality. 1 Internationally, guideline based approaches to pharmacotherapy for hypertension have been adopted to simplify clinical practice and improve blood pressure control. 2 3 4 Although some evidence suggests that the effectiveness of drug treatment for hypertension does not differ across the general population, 5 6 guideline recommendations hinge on the understanding that the effect of these drugs differs among specific subpopulations.
What is CPRD gold?
CPRD-GOLD is a nationally representative repository of prospectively collected, anonymised electronic health records from primary care in the UK , which has been extensively validated. 16 It holds data on demographic information, health related behaviours, test results including blood pressure measurements, diagnoses, and prescriptions for more than 11 million people. 16 The Hospital Episodes Statistics database records all hospital admissions for patients covered by the UK’s health service who receive treatment from either English NHS trusts or independent providers. 17 Almost 60% of general practices included in CPRD-GOLD are linked to Hospital Episodes Statistics. 16 We used linked data in this study to improve completeness of ethnicity recording. 18
Did patients have to be involved in the research question?
No patients were involved in setting the research question or the outcome measures, nor were they involved in developing plans for design or implementation of the study. No patients were asked to advise on interpretation or writing up of results.
