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The choice between the drugs is to a large degree determined by the characteristics of the patient being prescribed for, the drugs' side effects, and cost. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications.
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Goal blood pressure (mmHg) Initial treatment options ESC 2024 [2] General 120–129/70–79 BP >140/90: Two from different classes: preferably RAS-inhibitor (ACEI or ARB) with either thiazide diuretic/thiazide-like diuretic or dihydropyridine CCB. ESH 2023 [3] General age <65 General age 65–79 General age ≥80 <130/80 <140 SBP <150 SBP
In the absence of hydrostatic effects (e.g. standing), mean blood pressure decreases as the circulating blood moves away from the heart through arteries and capillaries due to viscous losses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries and arterioles. [75]
Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. [8] Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. [5] If lifestyle changes are not sufficient, blood pressure medications are used. [8]
Valsartan, sold under the brand name Diovan among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. [8] It belongs to a class of medications referred to as angiotensin II receptor blockers (ARBs). It is a reasonable initial treatment for high blood pressure. [8] It is taken by mouth. [8]
Lisinopril/amlodipine, sold under the brand name Lisonorm among others, is a medication used to treat high blood pressure. [1] It is a combination of lisinopril, an ACE inhibitor,with amlodipine, a calcium channel blocker. [1] It may be used when blood pressure is not well controlled with each of the two agents alone. [4] It is taken by mouth. [1]
Clonidine, sold under the brand name Catapres among others, is an α 2A-adrenergic receptor agonist [12] medication used to treat high blood pressure, ADHD, drug withdrawal (e.g., alcohol, opioids, or nicotine), menopausal flushing, diarrhea, spasticity, and certain pain conditions. [13]