The physician should explain the problems associa¬ted with drug therapy so that the patient will accept and comply with drug changes, which are often necessary.
The standard approach to antihypertensive treatment is to use a beta-blocker or a diuretic as the initial drug. In recent years beta-blockers have partially replaced diuretics as the first-line drug, but both drugs are advocated by national consensus committees as the recommended agents to commence treatment, except in special cases.
Experts vacillate between drugs as to their choice of a first-line drug. Other drugs can be used as first-line in selected individuals. Another important group of drugs that have proved beneficial in the treatment of moderate and severe hypertension are called angiotensin-converting enzyme (ACE) inhibitors. They are called this because they block the action of a series of enzymes (angiotensin, renin). (See chapter entitled Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers.) Angio¬tensin causes powerful constriction of arteries and therefore increases blood pressure when the body requires a boost in blood pressure. By blocking angiotensin, these drugs cause dilation of the arteries and a fall in blood pressure. In addition they do not stimulate the heart to beat faster as do some drugs. They also retain potassium whereas diuretics cause a loss of potassium. This group of drugs (ACE inhibitors) includes captopril and enalapril. Another group of drugs recommended by the consensus panel are the calcium blockers (antagonists).

Страницы: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30