2010 Hong Kong Reference Framework for Hypertension Care for ...
2010 Hong Kong Reference Framework for Hypertension Care for ...
2010 Hong Kong Reference Framework for Hypertension Care for ...
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Module 7Drug Treatment <strong>for</strong> People with <strong>Hypertension</strong>With reference to the UK and US guidelines, 5,12 the rationales on selectingdifferent classes of drugs <strong>for</strong> uncomplicated hypertensive patients are introducedbelow.Thiazide-type diureticsThiazide-type diuretics have been widely studied and shown to be the drug mostlikely to confer benefit as first-line treatment <strong>for</strong> most patients. 11,27,29 In thesetrials, including ALLHAT 7 thiazide-type diuretics had significantly preventthe cardiovascular complications of hypertension. Thiazide-type diuretics aregenerally well tolerated and have good blood pressure lowing effect in particularolder patients. Thiazide-type diuretics are also more af<strong>for</strong>dable than otherantihypertensive agents and are recommended as the initial therapy <strong>for</strong> mostpatients with hypertension by US guideline. 5Angiotensin-converting enzyme inhibitors (ACEI)/ Angiotensin II ReceptorAntagonists (ARB)It was demonstrated that younger patients and Caucasians tend to have higherserum renin levels than those older patients and the black population, and thusshould have better response to ACEI/ ARB which inhibit the renin-angiotensinsystem. 12,16,17,18ACEI/ ARB is recommended by the UK guideline 12 as theinitial drug choice <strong>for</strong> people aged
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