Alternatives to traditional first-line antihypertensive treatment: unresolved questions and therapeutic dilemmas. A personal approach.

Author:

Zusman R M1

Affiliation:

1. Hypertension Division, Massachusetts General Hospital, Boston 02114.

Abstract

The best antihypertensive regimen for use in patients with mild-to-moderate hypertension has not been determined. When nonpharmacological treatment of hypertension fails, initial drug treatment with diuretic drugs, sympatholytic agents (including beta-adrenergic receptor blockers), or vasodilators will result in satisfactory blood pressure control. However, each of these therapies has effects that are independent of their antihypertensive activity and that should be considered before a selection is made for initial therapy. The adverse effects of diuretic agents and beta-adrenergic receptor-blocking drugs on plasma lipid profiles may diminish the beneficial effects of blood pressure reduction. On the other hand, the hypocholesterolemic effect of alpha-adrenergic receptor antagonists, the potential cardioprotective effect of angiotensin converting enzyme inhibitors, and the salutary effects of calcium channel blockers on left ventricular function are responses that would support the use of vasodilatory therapy. Vasodilating antihypertensive drugs may be more beneficial than "standard" therapy and should be considered for the initial treatment of newly diagnosed hypertensive patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

Reference22 articles.

1. Kannel WB Sorlie P: Hypertension in Framingham in Paul O (ed): Epidemiology and Control of Hypertension. Miami Miami Symposia Specialists 1975

2. Multiple Risk Factor Intervention Trial

3. Antihypertensive therapy and lipids: Paradoxical influences on cardiovascular disease risk;Weinberger MH;Am J Med,1984

4. The Lipid Research Clinics Coronary Primary Prevention Trial Results

5. Adrenergic effects on plasma lipoprotein metabolism: Speculation on mechanisms of action

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Hypertension: Complications and Problems;Journal of the American Academy of Nurse Practitioners;1994-11

2. Essential Hypertension: Evaluation and Treatment;Journal of the American Academy of Nurse Practitioners;1994-09

3. Chapter 6. Antihypertensive Agents;Annual Reports in Medicinal Chemistry;1990

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