antihypertensive agents

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antihypertensive agents

drugs including angiotensin-converting enzyme (ACE) inhibitors (A), beta-blockers (B), calcium channel blockers (C) and diuretics (D) used to control hypertension; a combined drug approach is advocated, especially in patients with diabetes, e.g. A + C or B + D see (Table 1) local anaesthetics should be used with caution in patients taking antihypertensive drugs, especially beta-blockers (Table 2)
Table 1: Drug treatment of hypertension
Drug typeExamplesComments
Thiazide diureticsBendroflumethiazide
Chlortalidone (Hygroton)
Cyclopenthiazide (Navidrex)
Indapamide (Natrilix)
Metolazone (Metenix 5)
Xipamide (Diurexan)
Indicated for hypertension in elderly patients
Tend to exacerbate diabetes, gout, systemic lupus erythematosus
May cause postural hypotension
Beta-blockers ('.…lol')Propranolol (Inderal)
Acebutolol (Sectral)
Atenolol (Tenormin)
Bisoprolol (Cardicor)
Carvedilol (Eucardic)
Celiprolol (Celectol)
Esmolol (Brevibloc)
Labetalol (Transdate)
Metoprolol (Betaloc)
Nadolol (Corgard)
Nebivol (Nebilet)
Oxprenolol (Trasicor)
Pindolol (Visken)
Sotalol (Beta-Cardone)
Timolol (Betim)
Should not be used by patients with asthma or bradycardia or hypotension
Should be avoided in patients with a history of Raynaud's
May cause distal paraesthesia, impotence, dizziness and exacerbation of psoriasis
Angiotensin-converting enzyme (ACE) inhibitors ('..…pril')Captopril
Cilazapril (Vascace)
Enalapril (Innovace)
Fosinopril (Staril)
Imidapril (Tanatril)
Lisinpril (Carace; Zestril)
Moexipril (Perdix)
Perindopril (Coversyl)
Quinapril (Accupro)
Ramipril (Tritace)
Trandolapril (Gopten)
Used only with care in patients taking diuretics, or those with peripheral vascular disease, generalized atherosclerosis and kidney disease
May cause profound hypotension, persistent cough, renal impairment, angioedema and pruritic rashes
Angiotensin II receptor antagonists ('.…sartan')Candesartan (Animax)
Eprosartan (Teveten)
Irbesartan (Aprovel)
Losartan (Cozaar)
Olmesartan (Olmetec)
Telmisartan (Micardis)
Valsartan (Diovan)
Used only with caution in patients with aortic or mitral valve stenosis, or renal artery disease
Tend not to be effective in Afro-Caribbean patients with left ventricular hypertrophy
Calcium-channel blockers ('.…dipine')Amlodipine (Istin)
Diltiazem (Calcicard)
Felodipine (Plendil)
Isradipine (Prescal)
Lacidipine (Motens)
Lercadidipine (Zanidip)
Nicardipine (Cardene)
Nifedipine (Adalat)
Nimodipine (Nimotrop)
Nisoldipine (Syscor MR)
Verapamil (Cordilox)
May cause abdominal pain, nausea, flushing, oedema, headache, dizziness, constipation and sleep disturbance
Alpha-blockers ('.…zosin')Doxazosin (Cardura)
Indoramin (Baratol)
Prazosin (Hypovase)
Terazosin (Hytrin)
Should not be used in patients with urinary incontinence
Tend to cause hypotension, dizziness, vertigo, headache, fatigue

Where antihypertensive drugs are used in combination, a rule-of-thumb guide indicates:

A + C (ACE inhibitors + calcium channel blockers)

B + D (beta-blockers + diuretics)

Table 2: Types of adverse drug reaction
ACommon, dose-related, predictable, augmented drug effect in patients showing excessive response to normal drug dosage; managed by dose reduction
BBizarre, rare, unpredictable, non-dose-related, immunological-based, severe drug reaction; drug must be withdrawn immediately
CGradual reduction of drug effectiveness over time; due to adaptation/habituation
DDelayed effects of drug
EEnd-of-use withdrawal reaction
FUnexpected failure of therapeutic effect, possibly due to interaction with another drug
References in periodicals archive ?
Guidelines from the European Stroke Organization provide similar recommendations with regard to blood pressure thresholds for treatment; however, they do not recommend specific antihypertensive agents (European Stroke Organisation Executive Committee & Writing Committee, 2008).
d) Discontinue nonpharmacological management and start combination pharmacological management using two antihypertensive agents
If a diabetic woman who is taking an ACEI or ARB becomes pregnant, the drug must be stopped immediately and switched to another antihypertensive agent.
Previous studies of a possible link between breast cancer risk on the one hand and antihypertensive agents in general, and CCBs in particular, on the other hand, have produced inconsistent results.
1,2) An estimated 65 million Americans currently have hypertension, (3) and despite the availability of more than 100 antihypertensive agents, only 34% of all persons with hypertension and 56% of those treated reach the blood pressure (BP) goal of <140/90 mm Hg.
The finding that antihypertensive agents that protect against AD seem to do so independently of controlling blood pressure was of particular interest.
8] A preferred list of antihypertensive agents chosen based on their favorable and/or unfavorable effects on the patient's coexisting medical conditions are summarized in Table 1.
The report finds that patients tend to be most compliant with antihypertensive agents and erythropoiesis stimulating agents (ESAs) and least compliant with phosphate binders and lifestyle changes.
In addition to having an increased risk for lip cancer, patients taking photosensitizing antihypertensive agents are probably also at an increased risk for basal and squamous cell cancers of the skin, noted Dr.
My longstanding hypertension seemingly was controlled by several antihypertensive agents and conventional measures recommended by my personal physician.
Long-acting calcium channel blockers are significantly less effective than other antihypertensive agents in reducing the disease's major cardiovascular complications, according to a new metaanalysis.
is indicated for the treatment of hypertension when used alone or in combination with other antihypertensive agents.