Why not prescribe the best drugs for hypertension now?

S. Y.S. Wong, G. T. McInnes, T. M. MacDonald (Lead / Corresponding author)

    Research output: Contribution to journalReview article

    4 Citations (Scopus)

    Abstract

    As Westernised societies have become more affluent, the attitudes of the population have become more risk-aware. People are now intolerant of small risks as well as the physical or mental discomforts from drug side effects. Safety and tolerability are now major forces driving the development of new medicines for the treatment of chronic illnesses and the prevention of increasingly rare events. For example, over the past decades, lower and lower treatment thresholds have been recommended in hypertension. Public perception of risk strongly influences the acceptability of lifetime treatment, especially for mild hypertension. This era has also witnessed great advances in the development of antihypertensive drugs that combine efficacy with unsurpassed tolerability. However, the philosophy of Scottish teachers of Materia medica still appears to be followed-'never be the first or the last to prescribe a new drug'. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists are as safe and as efficacious as other anti hypertensive medications and better tolerated. Large trials (HOT, HOPE, UKPDS and PROGRESS) point to the need for rigorous control of blood pressure particularly in high-risk individuals. Anti hypertensive drugs that act on the renin-angiotensin system will probably impact significantly on achieving optimal blood pressure levels. Should it not now be accepted that high-risk patients should have ACE inhibitors and angiotensin II receptor antagonists prescribed as first-line agents? We review the evidence for the use of ACE inhibitors and angiotensin II receptor antagonists as antihypertensive agents.

    Original languageEnglish
    Pages (from-to)505-511
    Number of pages7
    JournalJournal of Human Hypertension
    Volume17
    Issue number7
    DOIs
    Publication statusPublished - 24 Jun 2003

    Fingerprint

    Antihypertensive Agents
    Angiotensin Receptor Antagonists
    Hypertension
    Angiotensin-Converting Enzyme Inhibitors
    Pharmaceutical Preparations
    Materia Medica
    Blood Pressure
    Renin-Angiotensin System
    Drug-Related Side Effects and Adverse Reactions
    Chronic Disease
    Therapeutics
    Safety
    Population

    Keywords

    • ACE inhibitors
    • Angiotensin II receptor antagonists
    • Renin-angiotensin system

    Cite this

    Wong, S. Y.S. ; McInnes, G. T. ; MacDonald, T. M. / Why not prescribe the best drugs for hypertension now?. In: Journal of Human Hypertension. 2003 ; Vol. 17, No. 7. pp. 505-511.
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    Why not prescribe the best drugs for hypertension now? / Wong, S. Y.S.; McInnes, G. T.; MacDonald, T. M. (Lead / Corresponding author).

    In: Journal of Human Hypertension, Vol. 17, No. 7, 24.06.2003, p. 505-511.

    Research output: Contribution to journalReview article

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