What are the treatment options for hypertension?

From the Guidelines

Hypertension treatment should prioritize lifestyle changes, including a heart-healthy diet low in sodium, regular physical activity, weight management, and limiting alcohol consumption, alongside medication, with the goal of achieving blood pressure below 130/80 mmHg, as recommended by the most recent guidelines 1.

Key Lifestyle Modifications

• Adopting a DASH-style eating pattern, rich in fruits, vegetables, and whole grains, and low in sodium (<2,300 mg/day) 1
• Regular physical activity, aiming for at least 150 minutes of moderate exercise weekly
• Weight management through caloric restriction
• Limiting alcohol consumption to no more than 2 servings per day in men and no more than 1 serving per day in women

First-Line Medications

• Thiazide diuretics, such as hydrochlorothiazide 12.5-25 mg daily
• ACE inhibitors, such as lisinopril 10-40 mg daily
• Angiotensin II receptor blockers, such as losartan 25-100 mg daily
• Calcium channel blockers, such as amlodipine 2.5-10 mg daily

Treatment Goals and Monitoring

• Blood pressure targets below 130/80 mmHg, with consideration for individualized targets based on age and comorbidities
• Regular blood pressure monitoring at home, with readings taken at the same time daily, after 5 minutes of rest, with the arm supported at heart level
• Medication selection and adjustment based on factors like age, ethnicity, and other health conditions, with many patients requiring multiple medications for adequate control 1

From the FDA Drug Label

Aliskiren tablets are indicated for the treatment of hypertension in adults and in pediatric patients weighing 50 kg or greater who are at least 6 years of age and older to lower blood pressure. Lisinopril tablets USP are indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older to lower blood pressure.

Treatment for Hypertension:

• Aliskiren tablets are indicated for the treatment of hypertension in adults and pediatric patients weighing 50 kg or greater who are at least 6 years of age and older.
• Lisinopril tablets USP are indicated for the treatment of hypertension in adult patients and pediatric patients 6 years of age and older. The recommended starting dose of aliskiren tablets is 150 mg once daily 2, and the recommended dosage of lisinopril tablets USP is not specified in the provided text. Key Considerations:
• Control of high blood pressure should be part of comprehensive cardiovascular risk management.
• Many patients will require more than one drug to achieve blood pressure goals.
• The absolute benefit of blood pressure reduction is greater in patients who are at higher risk independent of their hypertension 2 3.

From the Research

Treatment Options for Hypertension

• Lifestyle modification is the first-line therapy for hypertension, including weight loss, healthy dietary pattern with low sodium and high potassium intake, physical activity, and moderation or elimination of alcohol consumption 4, 5, 6
• The decision to initiate antihypertensive medication should be based on the level of blood pressure and the presence of high atherosclerotic cardiovascular disease risk 4
• First-line drug therapy for hypertension consists of a thiazide or thiazide-like diuretic, an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and a calcium channel blocker 4, 5, 7

Lifestyle Modifications

• Reducing dietary sodium intake and increasing physical activity can help lower blood pressure 8, 6
• The Dietary Approaches to Stop Hypertension (DASH) eating plan and sodium restriction are recommended for proper nutrition 5, 6
• Weight reduction and moderation of alcohol consumption are also important lifestyle modifications for patients with hypertension 4, 5, 6

Medication Therapy

• Thiazide diuretics, such as chlortalidone or hydrochlorothiazide, are often the first-choice treatment for hypertension 7
• Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and calcium channel blockers are also commonly used to treat hypertension 4, 5
• The choice of medication should be based on the individual patient's needs and medical history 4, 5, 7