Options in antihypertensive drug therapy. Help in choosing from among the many agents.
The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V) states that "because diuretics and beta blockers are the only classes of drugs that have been used in long-term controlled trials and shown to reduce morbidity and mortality, they are recommended as first choice agents unless they are contraindicated or unacceptable." These guidelines are important, but practitioners should remember that many effective and well-tolerated classes of drugs are available for treating hypertension, and one may have greater usefulness than another in a given patient. For example, an angiotensin-converting enzyme inhibitor may be appropriate in a patient with hypertension and congestive heart failure or diabetic nephropathy. A calcium channel blocker may be beneficial in a patient with hypertension and concomitant angina. Results of prospective studies comparing classes of antihypertensive drugs and measuring clinically significant end points may help guide pharmacotherapy in the future.
Barron
H V
HV
Overlake Internal Medicine, Bellevue, WA 98004, USA.
Amidon
T M
TM
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers