Antihypertensive Antihypertensive Captain (football) Category="Pharmacologic agents"Antihypertensives are a class of drugs that are used in Medicine and Pharmacology to treat Hypertension. There are many classes of antihypertensives, which—by varying means—act by lowering blood pressure. Evidence suggests that reduction of the Blood pressure by 5-6 mmHg can decrease the risk of stroke by 40%, of Coronary heart disease by 15-20%, and reduces the likelihood of Dementia, heart failure, and mortality from vascular disease.

Which type of medication to use initially for hypertension has been the subject of several large studies. The JNC7 (The Seventh Report of the Joint National Committee on Prevention of Detection, Evaluation and Treatment of High Blood Pressure) recommends starting with a Thiazide diuretic if single therapy is being initiated and a another medication is not indicated. This is based on a slightly better outcome for chlorothiazide in the ALLHAT study versus other anti-hypertensives and because thiazide diuretics are relatively cheap. Another large study (ANBP2) published after the JNC7 did not show this small difference in outcome and actually showed a slightly better outcome for ACE-inhibitors. The bottom line is this - the fundamental goal of treatment should be blood pressure control and in reality all three classes of medications are very effective.

Available drugs

Diuretics

Antiadrenergics

ACE inhibitors

Calcium channel blockers

Angiotensin II receptor antagonists

Aldosterone antagonists

Vasodilators

Choice

The choice between the drugs is to a large degree determined by their side-effects. For example, Asthmatics have been reported to have worsening symptoms when using beta blockers. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive (such as beta blockers in case of Tremor and Nervousness, and alpha blockers in case of Benign prostatic hyperplasia).

See also