Effective management of Hypertension with Additional Risk Factors - Global Hypertension Practice Guidelines
The 2020 Global Hypertension Practice Guidelines were developed by the International Society of Hypertension (ISH) Guidelines Committee based on evidence criteria to be used globally.
In addition to BP control, the therapeutic strategy should include lifestyle changes, body weight control and the effective treatment of the other risk factors to reduce the residual cardiovascular risk.
Following are the drugs of choice in hypertension with additional risk factors:
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Angiotensin converting enzyme inhibitors (ACEs) or Angiotensin receptor blockers (ARBs) or Beta-blockers irrespective of BP levels is the first-line of drugs in hypertensive patients with or without Calcium channel blockers (CCBs).
RAS-inhibitors are first-line drugs because they reduce albuminuria in addition to BP control. CCBs and diuretics can be added.
The treatment strategy may include an RAS inhibitor and a CCB and/or thiazide-like diuretic.
The treatment strategy may include an angiotensin receptor blocker (ARB) and CCB and/or diuretic.
BP should be lowered as done in the general population, preferentially with RAS-inhibitors (ARB, ACE) and CCBs.
BP should be lowered preferentially with RAS-inhibitors (ARB, ACE) and CCBs.
ACEs      angiotensin converting enzymes
ARBs      angiotensin AT-1 receptor blockers
CCBs      calcium channel blockers
RASÂ Â Â Â Â Â Â Â renin-angiotensin system
Â
Angiotensin receptor blockers (ARB):Â Telmisartan, Olmesartan, Valsartan
Calcium channel blockers (CCB):Â Amlodipine, Nifedipine, Diltiazem
Beta Blockers:Â Atenolol, Bisoprolol, Metoprolol
Diuretics:Â Hydrochlorothiazide, Indapamide, Furosemide
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