Drugs for hypertension. Seven classes to choose from

A wide variety of drugs are available for treatment of hypertension. Diuretics, long the sole therapy, can control blood pressure in more than 40% of patients. If a diuretic alone proves inadequate, a beta-adrenergic blocking agent, vasodilator, and central-acting sympathetic inhibitor may be added, as needed, in the familiar four-step program. A calcium channel blocker, with its vasodilating effects, or an angiotensin-converting enzyme inhibitor may be considered in appropriate situations. Selection among these agents should be based on knowledge of their pharmacologic action, duration of action, and side effects. With careful selection, blood pressure can be better controlled, side effects minimized, and patient compliance improved.