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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]
Resistant hypertension is defined as hypertension that remains above goal blood pressure in spite of using, at once, three antihypertensive medications belonging to different drug classes. Guidelines for treating resistant hypertension have been published in the UK [45] and US. [46]
Resistant hypertension: add spironolactone ACC / AHA 2017 [13] General <130/80 BP > 130/80: Lifestyle changes and monotherapy with thiazide-type diuretic, ACEI/ARB, and/or CCB BP >20/10 above target: Lifestyle changes and two from different classes: thiazide-type diuretic, ACEI/ARB, and/or CCB JNC 8 2013 [1] General age ≥60 General age <60 ...
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.
The fifth version in 1957 saw its name change to The British National Formulary. [ 4 ] [ 5 ] A new-look version, under the auspices of Owen Wade , was released in 1981. [ 2 ] [ 6 ] A study in Northern Ireland, looking at prescribing in 1965, reported that the BNF was likely able to serve the requirements of prescribers in general practice ...
If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication. Dietary changes shown to reduce blood pressure include diets with low sodium, [ 127 ] [ 128 ] the DASH diet (Dietary Approaches to Stop Hypertension), [ 129 ] which was the best against 11 other diet in ...
The term apparent refractory hypertension, as opposed to true refractory hypertension is used by investigators to refer to patients with resistant hypertension based on the number of prescribed medications, without accounting for common causes of pseudo-resistance, ie, inaccurate blood pressure measurements, nonadherence, undertreatment, or white-coat effects. [5]
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).