Hypertension & Drug Treatment

Hypertension, or high blood pressure, affects millions of Americans, and can lead to fatal heart attacks and strokes. Six major classes of antihypertensive drugs are currently in use: diuretics, beta-blockers (sympatholytics), vasodilators, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor antagonists. This paper will compare the effects of three of these types of drugs: beta-blockers, ACE inhibitors, and calcium channel blockers.

Beta-blockers are used to treat a variety of problems, including high blood pressure, arrhythmia, and angina, and have been shown to reduce the risk of recurrent heart attacks and death in people who have already had a heart attack (Health Beat, 1998). Some experts urge doctors to use beta-blockers for everyone who has survived a heart attack; others believe that the sickest patients, such as those with severe congestive heart failure, should be not be given them because they can sometimes worsen some conditions. As well as lowering blood pressure, beta-blockers cause peripheral vasoconstriction, negative inotropic and chronotropic action on the heart, bronchoconstriction, and accentuation of insulin resistance (Gavras, Manolis and Gavras, 1997).

Beta-blockers are widely used to treat hypertension for several reasons: they are relatively inexpensive; their effectiveness in helping control blood pressure masks their inadequacies in preventing chronic heart disease and cardiovascular mortalit

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ta-blockers and diuretics. Despite these data, some studies on older patients suggest that beta-blockers have no clinical function in first-line therapy of uncomplicated hypertension (Healthy Older Patients, 1998). For years, many clinicians have assigned their older patients with hypertension to beta-blocker therapy, but it is now believed that, while beta-blockers are better for secondary cardio-protection, older patients who have not experienced a first heart attack should be prescribed either a diuretic or a calcium channel blocker. A research study which examined the results from 10 clinical trials testing beta-blockers against a diuretic regimen looked at 16,000 hypertensive patients aged 60 and older. Of these patients, 8,217 received active treatment and were followed for an average of five years. Results showed that two-thirds of the patients on diuretic monotherapy were well-controlled, whereas less than one-third of the patients taking beta-blocker monotherapy were well-controlled. It was also found that the diuretics were effective in preventing cerebrovascular events, fatal strokes, coronary heart disease, and mortality from all causes, whereas the beta-blockers were not. ACE inhibitors (e.g. Catopril, Mon

Category: Medical - H