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Related Experiment Videos

Choosing initial therapy for hypertension. A personal view.

H R Black1

  • 1Section of Cardiology and Hypertension Service, Yale University School of Medicine, New Haven, Connecticut 06510.

Hypertension (Dallas, Tex. : 1979)
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

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Clinicians can now select from five classes of antihypertensive drugs for initial therapy, moving beyond just diuretics or beta-blockers. Patient-specific factors guide the optimal choice for effective hypertension management.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Numerous safe and effective antihypertensive medications are now available.
  • Traditional initial therapy often limited to diuretic agents or beta-adrenergic receptor blockers (beta-blockers).

Purpose of the Study:

  • To inform clinicians about the expanded options for initial hypertension monotherapy.
  • To guide the selection of appropriate antihypertensive agents based on patient-specific factors.

Main Methods:

  • Review of available antihypertensive drug classes and their suitability for monotherapy.
  • Analysis of factors influencing drug selection in hypertension management.

Main Results:

  • Five classes of antihypertensive agents are appropriate for initial monotherapy: angiotensin converting enzyme inhibitors, beta-blockers, calcium entry blockers, peripheral alpha 1-adrenergic receptor blockers, and thiazide diuretic agents.

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  • Drug choice depends on efficacy, side effects, patient demography, comorbidities, dosage, cost, mechanism of action, and pathophysiology.

    • Conclusions:

    • Clinicians should no longer restrict initial antihypertensive therapy to only diuretics or beta-blockers.
    • Extensive data support informed selection of the most probable successful antihypertensive agent for individual patients.