How to treat

Apply the rule "start low, go slow".

Depending on the severity of hypertension and cardiovascular risk, start with a drug combination.

Low cardiovascular risk and HTN grade I

  • Monotherapy.

High to very high cardiovascular risk and HTN grade I.

  • Monotherapy.

High to very high cardiovascular risk and HTN grade I.

  • Monotherapy or association.

High to very high cardiovascular risk and HTN grade II

  • Association
.

Antihypertensive drug choice based on co-morbidity.

Ischemic heart disease

  • ß-blockers.
  • Calcium channel blockers.
  • ACE.

Heart failure

  • Angiotensin II receptor antagonists.
  • ACE.
  • Diuretics.
  • ß-blockers.
  • Aldosterone receptor antagonists.

Asthma

  • ACE.
  • Angiotensin II receptor antagonists.
  • Diuretics.

Dyslipidemia

  • ACE.
  • Calcium channel blockers.

Diabetes, proteinuria

  • ACE.
  • Angiotensin II receptor antagonists.
  • ß-blockers.

Pregnancy

  • No diuretics or ACE.
  • Alpha-methyldopa (Aldomet).
  • Labetalol (Trandate).
  • Calcium channel blockers.
  • ß-blockers.