Antihypertensive Drugs Today

Michael Weber, MD, and a panel of distinguished authorities provide a comprehensive practical survey focusing on the key issues that determine the who, when, and how of hypertension management. Emphasis is given to the practical issues of management: how to select treatments that optimize results for even the most difficult-to-treat hypertensive patient, and what to do about the major concomitant problems. Examined in detail are the principal underlying mechanisms of hypertension, particularly those that help explain treatment choices, as well as the best techniques for successfully evaluating patients before treatment. Authoritative and eminently readable, Hypertension Medicine constitutes a highly practical account of the challenging issues faced daily by family physicians, internists, and general practitioners in the evaluation and optimal management of hypertension.

Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

Handbook of Hypertension, Volume 3: Pharmacology of Antihypertensive Drugs presents the biological and clinical knowledge in the field of hypertension. This book discusses the fundamental pharmacology of antihypertensive drugs. Organized into 12 chapters, this volume begins with an overview of the classification of antihypertensive mechanisms of drugs. This text then examines the effects of antihypertensive drugs in animal models and discusses the importance of these models and responses to human hypertension. Other chapters consider the pharmacological basis for the treatment of hypertension. This book discusses as well the various classes of antihypertensive drugs, which depends on two factors. The final chapter deals with the inhibitors of angiotensin-converting enzyme, which are essential in the drug treatment of hypertensive disease. This book is a valuable resource for clinicians, pharmacists, physiologists, epidemiologists, biological scientists, and general practitioners. Clinical investigators and medical students will also find this book extremely useful.

The purpose of the “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)” is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are: in those older than age 50, systolic blood pressure (SBP) of greater than 140 mmHg is a more important cardiovascular disease (CVD) risk factor than diastolic BP (DBP); beginning at 115/75 mmHg, CVD risk doubles for each increment of 20/10 mmHg; those who are normotensive at 55 years of age will have a 90 percent lifetime risk of developing hypertension; prehypertensive individuals (SBP 120–139 mmHg or DBP 80–89 mmHg) require health promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions, which are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (less than 140/90 mmHg, or less than 130/80 mmHg for patients with diabetes and chronic kidney disease); for patients whose BP is greater than 20 mmHg above the SBP goal or 10 mmHg above the DBP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will only be controlled if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.

Many of the nearly 70 million Americans with hypertension (high blood pressure) would like to bring it under control through lifestyle changes such as losing weight, cutting back on salt, exercising, or reducing stress. But, like it or not, most will require medication to get their blood pressure where it needs to be. The good news is that we have many excellent blood pressure medications which, when prescribed wisely, can control hypertension in almost everyone. The bad news is that, despite good intentions, doctors are placing millions of people who have hypertension on medications, drug combinations, or doses that are wrong for them, with staggering consequences that include uncontrolled hypertension, higher risk for stroke and heart attack, avoidable side effects, and billions of wasted health care dollars. Here, Dr. Mann, a nationally recognized hypertension specialist, identifies the drugs most likely to have side effects, and those that can be used in their place. He describes the shortcomings of some of the new drugs, while also introducing readers to some excellent old drugs that are woefully underused as a result of the publicity blitz surrounding the new, expensive ones. He emphasizes the importance of matching the medication and dosage to the individual who will be taking them, and presents the overlooked clues that can tell us who should be on which drug (even an excellent drug can be the wrong one if it is given to the wrong person or in the wrong dose). Hypertension and You is directed at the more than 50 million Americans (including a majority of people over the age of 60) who are taking blood pressure medication. Many patients suspect they might be on the wrong medication, but don’t know enough to be sure. This book shows how medications can be prescribed more wisely to achieve better results and gives patients the knowledge they need to capably discuss their medications with their health care providers. Hypertension and You provides many ideas and approaches that will be new to readers, and also to many physicians, and which no other book offers. It’s the first book to make the case that something is terribly wrong with how doctors are prescribing drugs for this condition. It provides readers with better knowledge of the available medications, empowering them to work with their physician to get onto the medications that are right for them.