Guidelines for Selecting Initial Drug Treatment of Hypertension | ||||
| CLASS OF DRUG | COMPELLING INDICATIONS | POSSIBLE INDICATIONS | COMPELLING CONTRAINDICATIONS | POSSIBLE CONTRAINDICATIONS |
|---|---|---|---|---|
| Diuretics | Heart failure | Gout | ||
| Elderly pts | ||||
| Systolic hypertension | ||||
| Beta blockers | Angina | Heart failure | Uncontrolled asthma and COPD | Athletes and physically active pts |
| After MI | Pregnancy | Heart blocka | ||
| Tachyarrhythmias | Peripheral vascular disease | |||
| ACE inhibitors | Heart failure | Chronic renal parenchymal disease | Pregnancy | |
| LV dysfunction | Hyperkalemia | |||
| Following an MI | Bilateral renal artery stenosis | |||
| Diabetic nephropathy | ||||
| Angiotensin receptor blockers | ACE inhibitor cough | Chronic renal parenchymal disease | Pregnancy | |
| Heart failure | Bilateral renal artery stenosis | |||
| Diabetic nephropathy | Hyperkalemia | |||
| Calcium channel blockers | Angina Elderly pts Systolic hypertension | Peripheral vascular disease | Heart 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.
Abbreviations: ARB, angiotensin receptor blocker; COPD, chronic obstructive pulmonary disease.