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Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
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]
As of 2018, the best available evidence favors low-dose thiazide diuretics as the first-line treatment of choice for high blood pressure when drugs are necessary. [5] Although clinical evidence shows calcium channel blockers and thiazide-type diuretics are preferred first-line treatments for most people (from both efficacy and cost points of ...
Telmisartan, sold under the brand name Micardis among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. [4] It is a reasonable initial treatment for high blood pressure. [4] It is taken by mouth. [4]
The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit [6] [16] [17] and others finding unclear benefit. [18] [19] [20] High blood pressure affects 33% of the population globally. [9] About half of all people with high blood pressure do not know that they have it. [9]
It is one of the preferred treatments for high blood pressure in pregnancy. [1] For other types of high blood pressure including very high blood pressure resulting in symptoms other medications are typically preferred. [1] It can be given by mouth or injection into a vein. [1] Onset of effects is around 5 hours and they last about a day. [1]
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]
Labetalol is a medication used to treat high blood pressure and in long term management of angina. [4] [5] This includes essential hypertension, hypertensive emergencies, and hypertension of pregnancy. [5] In essential hypertension it is generally less preferred than a number of other blood pressure medications. [4]