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Smart Choices in Hypertension Management: A Practical Guide for Doctors

Acknowledgment and Credit

This article draws inspiration and insights from the comprehensive and educational content originally shared on the Facebook page "Pharmacist note สรุปทุกอย่างที่อ่านเจอ".

The page provides valuable resources for medical professionals and students, offering detailed and practical information on clinical management and medical education. The summary here is adapted and extended for clarity and utility in a broader clinical context. All credit for the original conceptual framework and information belongs to the creators and contributors of this page.

We highly recommend visiting the page for more excellent medical content and guidance.




 

Introduction

Hypertension (HTN) remains a leading cause of cardiovascular morbidity and mortality worldwide. In resource-limited settings such as small community hospitals, the selection of antihypertensive drugs should balance efficacy, safety, affordability, and availability. This article outlines evidence-based and practical guidelines to optimize antihypertensive therapy in such contexts.


 

Key Concepts in Antihypertensive Drug Selection

  1. Prioritize Evidence-Based Drug Groups: Drugs with robust evidence for reducing cardiovascular outcomes include:

    • ACE inhibitors (ACEi)

    • Angiotensin receptor blockers (ARBs)

    • Calcium channel blockers (CCBs)

    • Thiazide diuretics

    • Beta-blockers (in specific conditions)

  2. Individualize Treatment Based on Comorbidities: Consider co-existing diseases (e.g., CKD, diabetes, or heart failure) to select the most suitable drug class.

  3. Avoid Harmful Combinations:

    • ACEi and ARBs: Avoid simultaneous use due to the risk of acute kidney injury (AKI) and hyperkalemia.

  4. Monitor Regularly for Safety and Efficacy: Baseline and follow-up laboratory tests (e.g., renal function, electrolytes) are crucial to minimize adverse effects.


 

Available Drug Groups in Small Community Hospitals

1. ACE Inhibitors (ACEi)

  • Example: Enalapril (5 mg, 20 mg tablets)

  • Maximum Dose: 40 mg/day

  • Key Features:

    • First-line therapy for HTN in CKD, heart failure (HFrEF), or proteinuria.

    • Adjust Dose for Renal Function:

      • CrCL 10-30 mL/min: Start with 2.5 mg/day.

      • CrCL <10 mL/min: Not recommended; if necessary, maximum 10 mg/day.

    • Common Side Effects: Dry cough (not dose-dependent), hyperkalemia.

    • Contraindications: History of angioedema, pregnancy, bilateral renal artery stenosis.

  • Monitoring:

    • Baseline and 2-4 week Cr, K+.

    • Discontinue if K+ > 5.5 mEq/L or eGFR decreases >25%.

2. Angiotensin Receptor Blockers (ARBs)

  • Example: Losartan (50 mg tablets)

  • Maximum Dose: 100 mg/day

  • Preferred Use:

    • Alternative to ACEi when cough is intolerable.

    • Added benefit in atrial fibrillation (AF) for reducing recurrence.

    • No dose adjustment needed for renal impairment.

3. Calcium Channel Blockers (CCBs)

  • Example: Amlodipine (5 mg tablets)

  • Maximum Dose: 10 mg/day

  • Indications:

    • Effective in isolated systolic HTN and HFrEF.

    • No renal adjustment required.

  • Common Side Effects: Peripheral edema, flushing.

4. Thiazide Diuretics

  • Example: Hydrochlorothiazide (HCTZ) (25 mg tablets)

  • Maximum Dose: 50-200 mg/day (dose-dependent)

  • Precautions:

    • Avoid in poorly controlled diabetes, gout, or dyslipidemia.

    • Electrolyte Monitoring: Risk of hypoK+, hypoNa+, hyperuricemia, hyperglycemia.

    • Adjust dose for CrCL <10 mL/min: Not recommended.

5. Beta-Blockers

  • Example: Atenolol (50 mg tablets)

  • Maximum Dose: 100 mg/day

  • Use Cases:

    • Post-myocardial infarction, AF rate control, or HFrEF.

  • Contraindications:

    • Avoid in severe asthma/COPD and decompensated heart failure.

  • Renal Adjustment:

    • CrCL 10-30 mL/min: Max 50 mg/day.

    • CrCL <10 mL/min: Max 25 mg/day.

6. Potassium-Sparing Diuretics

  • Example: Spironolactone (25 mg tablets)

  • Maximum Dose: 50-200 mg/day

  • Specific Use:

    • Resistant HTN, aldosterone antagonism in heart failure.

  • Renal Adjustment:

    • GFR <30 mL/min: Not recommended.

  • Monitoring: Hyperkalemia, gynecomastia.

7. Alpha-Blockers

  • Example: Doxazosin (2 mg tablets)

  • Maximum Dose: 8-16 mg/day

  • Key Notes:

    • Useful in coexisting benign prostatic hyperplasia (BPH).

    • Avoid in HFrEF.

  • Common Side Effect: Orthostatic hypotension.

8. Direct Vasodilators

  • Example: Hydralazine (25 mg tablets)

  • Maximum Dose: 300 mg/day

  • Indications:

    • Adjunct therapy in resistant HTN or heart failure (with nitrates).

  • Monitoring: Risk of lupus-like syndrome.


 

Practical Considerations

Patient Evaluation

  1. Baseline Testing:

    • Renal function, electrolytes, and EKG.

  2. Regular Monitoring:

    • Serum potassium and creatinine (especially with ACEi/ARB, diuretics).

Summary Table

Drug Class

Example

Max Dose

Key Monitoring

Special Considerations

ACEi

Enalapril

40 mg/day

Cr, K+

Avoid in pregnancy, bilateral RAS

ARBs

Losartan

100 mg/day

K+

No renal adjustment required

CCB

Amlodipine

10 mg/day

Edema

Safe in CKD

Thiazides

HCTZ

50-200 mg/day

Electrolytes, Uric acid

Avoid in gout, DM

Beta-Blockers

Atenolol

100 mg/day

HR, BP

Selective agents for asthma

Potassium-Sparing

Spironolactone

50-200 mg/day

K+, gynecomastia

Avoid if GFR <30 mL/min

Alpha-Blockers

Doxazosin

8-16 mg/day

BP (orthostatic)

Useful in BPH

Direct Vasodilators

Hydralazine

300 mg/day

Lupus-like syndrome

Used in combination therapy

References

  1. 2019 Thai Guidelines on Hypertension Treatment

  2. KDIGO 2021 Clinical Practice Guidelines for Blood Pressure in CKD

  3. ESC/ESH 2018 Guidelines on Hypertension

  4. JNC 8 Guidelines for Hypertension Management

  5. UpToDate® and ACC/AHA Hypertension Guidelines.

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