III. Management: Cardiovascular Conditions

  1. Left Ventricular Hypertrophy (Risk of sudden death)
    1. Central active agonists
    2. ACE Inhibitors
    3. Calcium Channel Blockers
  2. Congestive Heart Failure
    1. Systolic Dysfunction
      1. ACE Inhibitor or Angiotensin Receptor Blocker
      2. Diuretic
      3. Beta Blocker (use with caution, CIBIS II, MERIT-HF)
        1. High efficacy with Carvedilol
      4. Spironolactone (use with caution, RALES trial)
    2. Diastolic Dysyfunction
      1. Calcium Channel Blocker
  3. Coronary Artery Disease risk or Myocardial Infarction
    1. General
      1. Beta Blocker (e.g. Metoprolol Succinate)
      2. ACE Inhibitor (HOPE trial) or Angiotensin Receptor Blocker
      3. Thiazide Diuretic
    2. Angina
      1. Beta Blockers (e.g. Metoprolol Succinate)
      2. Calcium Channel Blockers
        1. Dihydropyridine Calcium Channel Blocker
          1. Consider for Hypertension, Angina (may be added to Beta Blocker)
          2. Amlodipine
        2. Non-Dihydropyridine Calcium Channel Blocker (e.g. Diltiazem, Verapamil)
          1. Avoid unless Beta Blocker not tolerated
  4. Atrial Tachycardia and Atrial Fibrillation
    1. Beta Blockers
    2. Nondihydropyridine Calcium antagonists
  5. Dyslipidemia
    1. Alpha antagonists
    2. Diuretics do not worsen Hyperlipidemia
    3. Beta Blockers do not worsen Hyperlipidemia
  6. Edema
    1. Avoid Calcium Channel Blockers (especially Amlodipine)
  7. Peripheral Vascular Disease
    1. These patients are high risk for cardiovascular event
    2. Calcium Channel Blocker
    3. Beta Blockers may be tolerated
      1. Previously thought to be contraindicated

IV. Management: Genitourinary Conditions

V. Management: Rheumatologic Conditions

VI. Management: Neurologic and psychiatric disorders

  1. Essential Tremor
    1. Noncardioselective Beta Blocker
  2. Migraine Headache
    1. Noncardioselective Beta-Blockers
    2. Nondihydropyridine Calcium antagonists
  3. Major Depression
    1. Avoid Beta Blockers
  4. Substance Abuse
    1. Labetolol (Combined alpha-Beta Blocker)
    2. Calcium Channel Blockers
    3. Nitrates

VII. Management: Miscellaneous Conditions

  1. Obstructive Pulmonary Disease (COPD or Asthma)
    1. Avoid Beta Blockers
  2. Perioperative Hypertension
    1. Beta Blockers should be use preventively
    2. Delay surgery until BP <180/110
  3. Peptic Ulcer Disease
    1. Avoid Calcium Channel Blockers
    2. Gastrointestinal Bleeding risk

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Related Studies

Ontology: Antihypertensive Agents (C0003364)

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
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