Newer Drug Choices in Hypertension Treatment

Abstract

Life style alterations and drug therapy are the main stay in the treatment of hypertension (HTN). Five classes of drugs, for example, angiotensin-converting enzyme inhibitor (ACEI), aldosterone receptor blocker (ARB), beta-blocker (BB), calcium channel blocker (CCB), and diuretics have been recommended by various guidelines and these agents are standard of care. This review focusses on certain agents which have become available or new data have emerged with the existing compound. Azilsartan, a recently approved ARB, has been shown to provide sustained and superior antihypertensive effect as compared to existing sartans. Nebivolol, a third-generation long-acting BB with vasodilatory effects, provides excellent hemodynamic and side effect profile. A number of third- and fourth-generation CCB (benidipine, azelnidipine, and cilnidipine) are available in our country. These compounds are highly vascular selective and display organ protection effects. The use of these agents can be individualized depending on the likely benefits. Spironolactone, an old drug with modest blood pressure lowering effects, has proved to be an excellent add-on fourth agent in patients with resistant HTN.