Antihypertensive Drug Therapy

The primary aim is to find for each patient, a drug or combination of drugs which lowers blood pressure effectively and is not contra-indicated for any reason in that patient, and which may be positively helpful in other ways.

Abstract

In general, the treatment of hypertension is very rewarding: headache and symptoms of heart failure are relieved, retinopathy regresses, hypertensive encephalopathy is prevented, the likelihood of cerebrovascular accidents is much less, and renal deterioration is halted or slowed. However, atheroma of medium-sized arteries is not prevented and the big problem to be solved at present is the continuing incidence of myocardial infarction and sudden death (presumably due to arrhythmia). The treatment of hypertension is not just a matter of prescribing drugs. To take a regimen of tablets year in and year out is a considerable act of faith on the part of the patient, and some patients need a good deal of help along the way. The exact level of blood pressure at which treatment is recommended, the age above or below which treatment is offered, and the drugs which can be used to lower blood pressure, will undoubtedly continue to change. An attempt has therefore been made to discuss general principles rather than to lay down rigid guide-lines for each clinical situation. The primary aim is to find for each patient, a drug or combination of drugs which lowers blood pressure effectively and is not contra-indicated for any reason in that patient, and which may be positively helpful in other ways. There is a continuing need in this field for a knowledgable and flexible approach if the maximum benefit (with minimum risk) for each individual patient is to be obtained from advances in drug therapy.