Antihypertensive Drug Therapy

ABSTRACT

Aggressive treatment of hypertension has been proved to reduce morbidity and mortality. Data from recent clinical trials indicate that, for all stages of hypertension, the target BP should be a maximum BP <140/90 mmHg, with diastolic BP values as low as 70 mmHg. For patients with diabetes mellitus or chronic renal disease, this target value should be even lower, <130/80 mmHg. As significant morbidity and mortality attributable to hypertension occur in patients who are not diagnosed as having hypertension but whose blood pressure is in prehypertension range, 120~139/80~89 mmHg, lowering BP levels in this group is recommended as well, with lifestyle modification or drug therapy for some indicated patients being first-line therapy. Because controlling BP to <140/90 mmHg often requires use of two or more agents, selection of drugs for combination therapy should be based not only on antihypertensive efficacy, but also on compelling indications and tolerability of the regimens. This review presents the latest findings on the antihypertensive therapy and emphasizes the importance of decreasing BP per the JNC-7 guidelines.