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Chlorthalidone is the thiazide drug that is most strongly supported by the evidence as providing a mortality benefit; in the ALLHAT study, a chlorthalidone dose of 12.5 mg was used, with titration up to 25 mg for those subjects who did not achieve blood pressure control at 12.5 mg. Chlorthalidone has repeatedly been found to have a stronger ...
The angiotensin II receptor blockers have differing potencies in relation to blood pressure control, with statistically differing effects at the maximal doses. [11] When used in clinical practice, the particular agent used may vary based on the degree of response required. Some of these drugs have a uricosuric effect. [12] [13]
Moxonidine is a new-generation alpha-2/imidazoline receptor agonist antihypertensive drug licensed for the treatment of mild to moderate essential hypertension. [5] [6] It may have a role when thiazides, beta-blockers, ACE inhibitors, and calcium channel blockers are not appropriate or have failed to control blood pressure.
Telmisartan is, on the other hand, in part metabolized by glucuronidation and olmesartan is excreted as the unchanged drug. [23] Telmisartan is the only ARB that can cross the blood–brain barrier and can therefore inhibit centrally mediated effects of Ang II, contributing to even better blood pressure control. [1]
It may be used alone or in addition to other blood pressure medication. [4] Up to six weeks may be required for the full effects to occur. [4] Common adverse effects include muscle cramps, stuffy nose, dizziness, cough, high blood potassium, and anemia. [4] Severe adverse effects may include angioedema, low blood pressure, and kidney problems. [4]
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]
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