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The first large study to show a mortality benefit from antihypertensive treatment was the VA-NHLBI study, which found that chlorthalidone was effective. [50] The largest study, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) in 2002, concluded that chlorthalidone (a thiazide-like diuretic) was as effective ...
They are one of the three major causes of death in pregnancy (16%) along with post partum bleeding (13%) and puerperal infections (2%). [6] Hypertensive disorders during pregnancy, such as gestational hypertension, preeclampsia, and eclampsia, are a major contributor to maternal and fetal illness and death on a worldwide scale.
It can be an adjunct to first-line antihypertensive agents in patients with accompanying comorbidities, for example, congestive heart failure, where selected beta blockers can be added in patients who remain mildly to moderately symptomatic despite appropriate doses of an angiotensin-converting-enzyme inhibitor. [19]
The recommended blood pressure goal is advised as <150/90 mmHg, with thiazide diuretic, CCB, ACEI, or ARB being the first-line medication in the United States. [42] In the revised UK guidelines, calcium-channel blockers are advocated as first line, with targets of clinic readings <150/90, or <145/85 on ambulatory or home blood pressure monitoring.
Hydralazine is often used to treat hypertension in pregnancy, though, with either labetalol and/or methyldopa. [11] Hydralazine is commonly used in combination with isosorbide dinitrate for the treatment of congestive heart failure in black populations. This preparation, isosorbide dinitrate/hydralazine, was the first race-based prescription ...
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
During pregnancy, the challenge is to determine when to use antihypertensive medications and which level of blood pressure to target. [30] A balance has to be found between the potential risk to the health of the baby related to drug-exposure and the risk to the mother and baby due to an untreated medical condition (severe hypertension). [31]
Reserpine is recommended as an alternative drug for treating hypertension by the JNC 8. [11] A 2016 Cochrane review found reserpine to be as effective as other first-line antihypertensive drugs for lowering of blood pressure. [12]