Treating hypertension in active patients: which agents work best with exercise?

Hypertension treatment typically involves drug and nondrug therapies. For patients already exercising and those trying to start, physicians need to be aware of the intricacies of antihypertensive medications, including side effect profiles and whether they are banned by some sports organizations. Although diuretics and beta-blockers have been used in the past by most physicians, in active patients we typically opt for newer agents such as ACE inhibitors, angiotensin-II-receptor blockers, dihydropyridine calcium channel blockers, and alpha-1 blockers. These drugs typically have fewer side effects and impediments to athletic performance. Other drugs may be used in active patients who have other medical problems or when cost is a concern.