What is the initial antihypertensive treatment for hypertension (high blood pressure)?
A number of pharmaceutical agents, well evidenced by large randomized clinical trials, are available for initial treatment of high BP. These include older molecules such as thiazide diuretics and beta-blocking agents and newer molecules, dihydropyridine calcium channel blockers (CCB), angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers …
What is the first-line pharmacologic treatment for hypertension (high blood pressure) in blacks?
Feb 14, 2018 · Morning Report Questions Q: What drug classes are recommended for the initial management of hypertension? A: Multiple clinical trials have shown that blood pressure can be effectively reduced by medications and that doing so results in a reduced incidence of target-organ events. The initial agent can be selected from one of four drug classes: angiotensin …
How many antihypertensive agents are needed to treat primary hypertension (PH)?
Mar 23, 2022 · Which agents are preferred for the initial treatment of hypertension? A) ACE inhibitors and angiotensin receptor antagonists B) Calcium ion agonists and central-acting alpha agonists C) Thiazide diuretics and beta-adrenergic blockers D) Direct vasodilators and peripherally acting adrenergic antagonists
Do you need more than one antihypertensive drug to control hypertension?
Feb 15, 2018 · The initial antihypertensive agent should generally be selected from one of four drug classes shown to reduce cardiovascular events: ACE inhibitors, angiotensin-receptor blockers, calcium-channel...
What is the first choice for blood pressure treatment?
Angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), and beta blockers are recommended as first-choice medications in some younger adults with high blood pressure. They are all effective at lowering blood pressure, but differ in the ways they work.Feb 24, 2022
What agent is used to treat hypertension?
Diuretics. There are three classes of diuretic drugs that are used to treat hypertension. Most commonly used are thiazide diuretics such as hydrochlorothiazide or chlorthalidone. There is not usually an increased urine flow after the first one or two days of taking these medications.
How do diuretics treat hypertension?
Diuretics help rid your body of sodium and water. Most work by making your kidneys release more sodium into the urine. The sodium then takes water with it from your blood decreasing the amount of fluid flowing through your blood vessels hence lowering blood pressure.
Are alpha-blockers used to treat hypertension?
What are alpha-blockers? Alpha-blockers are medications that treat high blood pressure. They can also treat some conditions affecting the circulatory system, prostate, and help with treating certain types of tumors. They work by slowing down specific types of cell activity in your nervous system.Jan 18, 2022
What drug classes are recommended for the initial management of hypertension?
Although in recent years hypertension has been defined as a blood pressure of 140/90 mm Hg or more, the 2017 American College of Cardiology–American Heart Association (ACC–AHA) Hypertension Guideline adopted a lower threshold, in which hypertension is defined as a systolic blood pressure of 130 mm Hg or more or a diastolic blood pressure of 80 mm Hg or more.
Clinical Pearls
A: Treatment decisions depend on whether there is preexisting cardiovascular disease, diabetes mellitus, or chronic kidney disease.
Morning Report Questions
A: Multiple clinical trials have shown that blood pressure can be effectively reduced by medications and that doing so results in a reduced incidence of target-organ events.
What are the factors that increase the risk of hypertension?
Lifestyle factors that are associated with an increased risk of hypertension and greater severity include high sodium intake, 5 weight gain and obesity, 6 excess alcohol intake, 7 and the use of certain medications, particularly nonsteroidal antiinflammatory drugs (NSAIDs), stimulants, and decongestants.
What is the classification of blood pressure?
Classification of Blood Pressure in Adults. Hypertension, the elevation of systolic blood pressure, diastolic blood pressure, or both above normal levels, is common in developed and developing countries and increases in prevalence with age.
What are the different types of medications used for hypertension?
Four main classes of medications are used in combination therapy for the treatment of hypertension: thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs). ACEIs and ARBs should not be used simultaneously.
How many antihypertensive agents are needed for primary hypertension?
More than 70% of adults treated for primary hypertension will eventually require at least two antihypertensive agents, either initially as combination therapy or as add-on therapy if monotherapy and lifestyle modifications do not achieve adequate blood pressure control. Four main classes of medications are used in combination therapy for ...
Does angiotensin converting enzyme inhibitor affect renal function?
A meta-analysis showed that angiotensin-converting enzyme inhibitors—but not angiotensin receptor blockers—reduced the incidence of doubling of the serum creatinine level in patients with diabetes mellitus, but it did not affect progression to end-stage renal disease.
Does monotherapy control blood pressure?
However, in a randomized controlled trial, patients who started on monotherapy eventually achieved blood pressure control similar to that of patients who started on combination therapy .
Does combination therapy increase blood pressure?
The use of combination antihypertensive agents as initial therapy has increased since 2003. 16, 17 Compared with monotherapy, initial combination therapy improves the average decrease in blood pressure and achieves blood pressure control faster, with similar tolerability. 9, 18, 19 However, patients who start on monotherapy eventually achieve similar blood pressure control as those who started on combination therapy. 10
Can antihypertensive medications be used for blood pressure?
In some cases, antihypertensive medications may be used to treat the underlying disease regardless of blood pressure. For this reason, these recommendations should be used in conjunction with disease-specific guidelines.
Is diabetes mellitus a modifiable risk factor?
Patients with diabetes mellitus should be treated similarly to those without diabetes unless proteinuria is present, in which case combination therapy should include an ACEI or ARB. Cardiovascular disease is the leading cause of death worldwide, and hypertension is a modifiable risk factor for cardiovascular disease.
What is the first line of medication for hypertension?
First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target.
What causes elevated BP?
Despite the prevalence of hypertension, approximately 90% to 95% of American adults with elevated BP are found to have no identifiable cause for their condition. Of the 5% with known causes, renal parenchymal and renovascular diseases are the most common culprits.1Other notable etiologies for hypertension include1: 1 Chronic kidney disease 2 Coarctation of the aorta 3 Cushing syndrome 4 Obstructive sleep apnea 5 Medications 6 Pheochromocytoma 7 Primary hyperaldosteronism 8 Renovascular disease 9 Thyroid/parathyroid disease.
How do CCBs affect BP?
CCBs lower BP by preventing the entry of calcium into vascular smooth muscles, resulting in vasodilation and reduced vascular contract ility. The 2 types of CCBs are (1) dihydropyridines, which act on peripheral blood vessels, and (2) nondihydropyridines, which act on cardiac muscles and peripheral blood vessels.
Is hypertension a public health problem?
Hypertension is a significant and costly public health problem. It is a major, but modifiable contributor for the development of cardiovascular disease.
