II. Management: Endocrine Conditions
-
Diabetes Mellitus (with or without Diabetic Nephropathy)
- See Hypertension in Diabetes Mellitus
- ACE Inhibitor or Angiotensin Receptor Blocker
- In black patients, use Calcium Channel Blocker or Thiazide Diuretic instead
- Obesity
III. Management: Cardiovascular Conditions
-
Left Ventricular Hypertrophy (Risk of sudden death)
- Central active Agonists
- ACE Inhibitors
- Calcium Channel Blockers
-
Congestive Heart Failure
-
Systolic Dysfunction
- ACE Inhibitor or Angiotensin Receptor Blocker
- Diuretic
-
Beta Blocker (use with caution, CIBIS II, MERIT-HF)
- High efficacy with Carvedilol
- Spironolactone (use with caution, RALES trial)
- Diastolic Dysyfunction
-
Systolic Dysfunction
-
Coronary Artery Disease risk or Myocardial Infarction
- General
- Beta Blocker (e.g. Metoprolol Succinate)
- ACE Inhibitor (HOPE trial) or Angiotensin Receptor Blocker
- Thiazide Diuretic
- Angina
- Beta Blockers (e.g. Metoprolol Succinate)
- Calcium Channel Blockers
- Dihydropyridine Calcium Channel Blocker
- Consider for Hypertension, Angina (may be added to Beta Blocker)
- Amlodipine
- Non-Dihydropyridine Calcium Channel Blocker (e.g. Diltiazem, Verapamil)
- Avoid unless Beta Blocker not tolerated
- Dihydropyridine Calcium Channel Blocker
- General
-
Atrial Tachycardia and Atrial Fibrillation
- Beta Blockers
- Nondihydropyridine calcium Antagonists
- Dyslipidemia
- Alpha Antagonists
- Diuretics do not worsen Hyperlipidemia
- Beta Blockers do not worsen Hyperlipidemia
-
Edema
- Avoid Calcium Channel Blockers (especially Amlodipine)
-
Peripheral Vascular Disease
- These patients are high risk for cardiovascular event
- Calcium Channel Blocker
-
Beta Blockers may be tolerated
- Previously thought to be contraindicated
IV. Management: Genitourinary Conditions
-
Benign Prostatic Hyperplasia
- Alpha Antagonist
- Avoid Diuretics
- Chronic Kidney Disease
- Pregnancy
- Methyldopa
- Hydralazine
- Labetolol
- Do not use ACE Inhibitor
V. Management: Rheumatologic Conditions
-
Gout
- Avoid Thiazide Diuretics
-
Osteoporosis
- Thiazide Diuretics (may prevent Hip Fractures)
VI. Management: Neurologic and psychiatric disorders
-
Essential Tremor
- Noncardioselective Beta Blocker
-
Migraine Headache
- Noncardioselective Beta-Blockers
- Nondihydropyridine calcium Antagonists
-
Major Depression
- Avoid Beta Blockers
-
Substance Abuse
- Labetolol (Combined alpha-Beta Blocker)
- Calcium Channel Blockers
- Nitrates
VII. Management: Miscellaneous Conditions
- Obstructive Pulmonary Disease (COPD or Asthma)
- Avoid Beta Blockers
- Perioperative Hypertension
- Beta Blockers should be use preventively
- Delay surgery until BP <180/110
-
Peptic Ulcer Disease
- Avoid Calcium Channel Blockers
- Gastrointestinal Bleeding risk
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Definition (MEDLINEPLUS) |
High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight and reducing sodium in your diet, you may need medicines. Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one. NIH: National Heart, Lung, and Blood Institute |
Definition (NCI) | Any substance used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Antihypertensive agents include diuretics, alpha-adrenergic and beta-adrenergic antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents. |
Definition (CSP) | agent that reduces high blood pressure. |
Definition (MSH) | Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. |
Concepts | Pharmacologic Substance (T121) |
MSH | D000959 |
SnomedCT | 1182007, 372586001 |
LNC | LP31453-1 |
English | Agents, Antihypertensive, antihypertensive agent, Antihypertensive Drugs, Agents, Anti-Hypertensive, Anti Hypertensive Agents, Anti Hypertensive Drugs, Anti Hypertensives, Anti-Hypertensive Agents, Anti-Hypertensive Drugs, Anti-Hypertensives, Antihypertensives, Drugs, Anti-Hypertensive, Drugs, Antihypertensive, antihypertensives (medication), antihypertensives, anti hypertensive, antihypertensives drugs, anti hypertensive drug, anti-hypertensive drugs, hypotensive agent, antihypertensive drug, antihypertensive drugs, anti hypertensives, antihypertensive, antihypertensive agents, hypotensive agents, anti-hypertensives, anti hypertensive drugs, blood pressure lowering drug, Antihypertensive Agents, Antihypertensive medicines, Antihypertensive Medicines, High Blood Pressure Medicines, High blood pressure medicines, Blood Pressure Medicines, ANTIHYPERTENSIVES, Hypotensive agents, Antihypertensive drug, Antihypertensive, Hypotensive agent (product), Hypotensive agent (substance), Hypotensive agent, Antihypertensive agent, Antihypertensive agent, NOS, Antihypertensive drug, NOS, Hypotensive agent, NOS, Hypotensive Agents, Hypotensive Drugs, Hypotensives, Antihypertensive Agent |
French | Agents antihypertenseurs, Médicaments antihypertenseurs, Anti-hypertenseurs, Antihypertenseurs |
Swedish | Blodtryckssänkande medel |
Czech | hypotenzíva, antihypertenzíva, hypotonika |
Finnish | Verenpainelääkkeet |
Italian | Farmaci antiipertensivi, Antiipertensivi |
Russian | GIPOTENZIVNYE SREDSTVA, ANTIGIPERTENZIVNYE SREDSTVA, АНТИГИПЕРТЕНЗИВНЫЕ СРЕДСТВА, ГИПОТЕНЗИВНЫЕ СРЕДСТВА |
Croatian | ANTIHIPERTENZIVI |
Polish | Leki obniżające ciśnienie, Leki hipotensyjne, Leki przeciwnadciśnieniowe |
Japanese | 血圧下降剤, 降圧剤, 抗高血圧症薬, 抗高血圧薬, 血圧降下剤, 血圧降下薬, 降圧物質, 降圧薬 |
Spanish | Antihipertensivos, Fármacos Antihipertensivos, Agentes Antihipertensivos, agente antihipertensivo, agente hipotensor (producto), agente hipotensor (sustancia), agente hipotensor, droga antihipertensiva |
Norwegian | Blodtrykkssenkende midler |
Portuguese | Agentes Anti-Hipertensivos, Fármacos Anti-Hipertensivos, Anti-Hipertensivos |
German | Antihypertonika, Blutdrucksenkende Mittel, Antihypertensiva |