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Table 119-3

Guidelines for Selecting Initial Drug Treatment of Hypertension

CLASS OF DRUGCOMPELLING INDICATIONSPOSSIBLE INDICATIONSCOMPELLING CONTRAINDICATIONSPOSSIBLE CONTRAINDICATIONS
DiureticsHeart failure Gout
Elderly pts
Systolic hypertension
Beta blockersAnginaHeart failureUncontrolled asthma and COPDAthletes and physically active pts
After MIPregnancyHeart blocka
Tachyarrhythmias Peripheral vascular disease
ACE inhibitorsHeart failureChronic renal parenchymal diseasePregnancy
LV dysfunction Hyperkalemia
Following an MI Bilateral renal artery stenosis
Diabetic nephropathy
Angiotensin receptor blockersACE inhibitor coughChronic renal parenchymal diseasePregnancy
Heart failure Bilateral renal artery stenosis
Diabetic nephropathy Hyperkalemia
Calcium channel blockers

Angina

Elderly pts

Systolic hypertension

Peripheral vascular diseaseHeart blockb Heart failure with reduced ejection fractionc

a Second- or third-degree atrioventricular block.

b Second- or third-degree atrioventricular block with verapamil or diltiazem.

c Verapamil or diltiazem.

Abbreviations: ARB, angiotensin receptor blocker; COPD, chronic obstructive pulmonary disease.