From the Guidelines
You should consult with a qualified healthcare provider to determine the most suitable medication, dosage, and duration of treatment for your condition, considering evidence-based guidelines such as those from the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1. When managing hypertension, it's essential to consider the potential effects of various medications and substances on blood pressure, as outlined in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1. Some key points to consider include:
- Avoiding or limiting the use of certain substances that may cause elevated blood pressure, such as alcohol, amphetamines, and nonsteroidal anti-inflammatory drugs (NSAIDs) 1.
- Considering alternative medications or therapies for conditions such as attention-deficit/hyperactivity disorder (ADHD), depression, and anxiety, which may have a lower risk of increasing blood pressure 1.
- Using medications that have demonstrated effective reduction of blood pressure and cardiovascular disease events, such as ACE inhibitors, ARBs, dihydropyridine CCBs, and diuretics, as first-line treatments 1.
- Combining medications, such as a RAS blocker with a dihydropyridine CCB or diuretic, to achieve better blood pressure control 1. It's crucial to weigh the benefits and risks of different treatment options and to individualize treatment based on a patient's specific needs and circumstances, as recommended by the 2024 ESC guidelines 1. Ultimately, the decision of what to prescribe should be made by a qualified healthcare provider who can evaluate the patient's specific situation and provide personalized recommendations 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Aspirin Prescription Considerations
- The use of aspirin for primary cardiovascular prevention in patients with diabetes is uncertain, with recent studies suggesting that the traditional once-daily, low-dose regimen may not provide a significant net clinical benefit 2.
- The US Preventive Services Task Force recommends aspirin use for primary prevention of cardiovascular disease in adults aged 40 to 59 years with a 10% or greater 10-year cardiovascular risk, but advises against its use in adults 60 years or older 3.
- Aspirin may not be beneficial for primary prevention of cardiovascular events in patients at elevated risk for cardiovascular disease and may increase the risk of major bleeding events 4.
Alternative Treatment Options
- A fixed-dose combination of amlodipine and atorvastatin has been shown to improve clinical outcomes in patients with concomitant hypertension and dyslipidemia, reducing the risk of major adverse cardiovascular events 5.
- Extended-release acetylsalicylic acid formulations have been developed to provide 24-hour anti-thrombotic coverage with once-daily dosing, potentially offering a more effective treatment option for secondary prevention of cardiovascular events 6.
Patient-Specific Factors
- Patient characteristics, such as diabetes, obesity, and bleeding risk, should be taken into account when considering aspirin prescription 2, 3.
- The decision to initiate aspirin use for primary prevention of cardiovascular disease should be individualized, considering the patient's risk factors, willingness to take daily medication, and potential for bleeding complications 3.