From the Guidelines
Hypertension treatment should prioritize lifestyle modifications and medication, with a focus on reducing morbidity, mortality, and improving quality of life, as recommended by the most recent guidelines 1.
Lifestyle Modifications
Lifestyle changes are essential for managing hypertension, including:
- Adopting a heart-healthy diet low in sodium (less than 2,300 mg daily) and rich in fruits, vegetables, whole grains, and lean proteins 1
- Regular physical activity (at least 150 minutes of moderate exercise weekly) 1
- Weight management, limiting alcohol consumption, and quitting smoking 1
Medication
First-line medications for hypertension include:
- Thiazide diuretics (like hydrochlorothiazide 12.5-25 mg daily) 1
- ACE inhibitors (such as lisinopril 10-40 mg daily) 1
- ARBs (like losartan 25-100 mg daily) 1
- Calcium channel blockers (amlodipine 5-10 mg daily) 1 Treatment typically begins with a single medication at a low dose, with adjustments based on blood pressure response, and many patients require two or more medications for adequate control 1.
Resistant Hypertension
For patients with resistant hypertension, the addition of low-dose spironolactone to existing treatment, or further diuretic therapy, should be considered 1.
Monitoring and Goals
Regular blood pressure monitoring is crucial, aiming for readings below 130/80 mmHg for most adults, to reduce the risk of cardiovascular events and improve quality of life 1.
From the FDA Drug Label
Losartan is indicated for the treatment of hypertension in adults and pediatric patients 6 years of age and older, to lower blood pressure. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) 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. Many patients will require more than 1 drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)
Treatment of Hypertension:
- Losartan and lisinopril are indicated for the treatment of hypertension in adults and pediatric patients 6 years of age and older.
- The goal is to lower blood pressure to reduce the risk of fatal and nonfatal cardiovascular events.
- Comprehensive Management: Control of high blood pressure should be part of comprehensive cardiovascular risk management, including:
- Lipid control
- Diabetes management
- Antithrombotic therapy
- Smoking cessation
- Exercise
- Limited sodium intake
- Guidelines: For specific advice on goals and management, refer to published guidelines, such as those of the National High Blood Pressure Education Program’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) 2 3.
From the Research
Treatment Options for Hypertension
- Lifestyle modification is the first-line therapy for hypertension, including weight loss, healthy dietary pattern, physical activity, and moderation or elimination of alcohol consumption 4
- 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, 6
Medication Options
- Thiazide diuretics, such as chlortalidone or hydrochlorothiazide, are recommended as first-line treatment for hypertension 5, 6
- Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, such as enalapril or candesartan, are also recommended as first-line treatment 4, 6
- Calcium channel blockers, such as amlodipine, are recommended as first-line treatment for hypertension 4, 6
Lifestyle Modifications
- The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for patients with hypertension 6, 7
- Sodium restriction and potassium supplementation are also recommended 4, 7
- Regular exercise and moderate weight loss are associated with improvements in blood pressure 6, 7
- Moderation or elimination of alcohol consumption is also recommended 4, 7