Authors: Higgins, Bernard; Williams, Bryan; Guideline Development Group,

Source: Clinical Medicine, Journal of the Royal College of Physicians, Volume 7, Number 6, December 2007 , pp. 612-616(5)

Publisher: Royal College of Physicians

Abstract:

Hypertension is a major risk factor for cardiovascular disease, and is both common and amenable to treatment. Several major new studies have appeared recently and in response the National Institute for Health and Clinical Excellence and the British Hypertension Society have collaborated to update their respective guidelines on primary hypertension, and to agree joint recommendations. The update focuses only on pharmacological aspects of treatment. Wherever possible, the recommendations are based on the clinical outcomes of mortality, stroke, myocardial infarction, heart failure, and new onset diabetes mellitus, rather than on blood pressure lowering. A brief treatment algorithm is included. In summary, either calcium channel inhibitors or thiazide-type diuretics should be the preferred initial agent for use in primary hypertension in most patients, although angiotensin converting enzyme (ACE) inhibitors (including angiotensin-II receptor inhibitors if ACE-intolerant) are preferred in patients younger than 55.

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Keywords: ANGIOTENSIN CONVERTING ENZYME INHIBITORS; ANGIOTENSIN RECEPTOR BLOCKERS; BETA-BLOCKERS; CALCIUM CHANNEL INHIBITORS; PRIMARY HYPERTENSION; THIAZIDE-TYPE DIURETICS

Document Type: Research article

Publication date: 2007-12-01

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• Clinical Medicine is published six times a year and circulated to 20,000 Fellows and Members of the Royal College of Physicians. The journal is read by physicians both established and in training in hospitals across the world. It features a wide range of articles including original papers, professional issues, clinical guidance, medical humanities, ethics and clinical governance. The journal publishes the key features from the College lectures and conferences. Each issue has a CME section which reviews the latest advances in a chosen specialty.
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