What is the recommended treatment for hypertension?

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Last updated: May 31, 2025 • View editorial policy

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From the Guidelines

The recommended treatment for hypertension is to use ACE inhibitors, ARBs, dihydropyridine CCBs, or diuretics as first-line treatments, with a preference for combination therapy, as stated in the 2024 ESC guidelines 1. When considering the treatment of hypertension, it's essential to prioritize medications that have demonstrated the most effective reduction of blood pressure and cardiovascular disease events.

  • The 2024 ESC guidelines recommend ACE inhibitors, ARBs, dihydropyridine CCBs, and diuretics as first-line treatments 1.
  • Combination therapy is recommended for most patients with confirmed hypertension, with preferred combinations including a RAS blocker with a dihydropyridine CCB or diuretic 1.
  • Fixed-dose single-pill combination treatment is also recommended for patients receiving combination therapy 1.
  • If blood pressure is not controlled with a two-drug combination, increasing to a three-drug combination is recommended, usually a RAS blocker with a dihydropyridine CCB and a thiazide/thiazide-like diuretic 1. Benicar, an ARB, can be considered as part of the treatment regimen, especially in combination with other medications.
  • However, the choice of medication should be individualized based on patient characteristics, such as comorbidities and potential side effects.
  • It's also important to note that lifestyle modifications, such as adopting a healthy diet, reducing sodium intake, and engaging in regular physical activity, are essential components of hypertension management 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)

The recommended treatment for hypertension is to lower blood pressure, and losartan may be used for this purpose.

  • It is indicated for adults and pediatric patients 6 years of age and older.
  • Comprehensive cardiovascular risk management is recommended, including lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake.
  • Many patients will require more than one drug to achieve blood pressure goals, and losartan may be administered with other antihypertensive agents 2.

From the Research

Treatment Options for Hypertension

The recommended treatment for hypertension includes various antihypertensive medications, such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]) and calcium channel blockers (CCBs).

Benicar (Olmesartan Medoxomil) as a Treatment Option

  • Olmesartan medoxomil (Olmetec, Benicar) is an ARB that inhibits the actions of angiotensin II on the renin-angiotensin-aldosterone system, which plays a key role in the pathogenesis of hypertension 3.
  • Oral olmesartan medoxomil 10-40 mg once daily is recommended for the treatment of adult patients with hypertension 3.
  • In those with inadequate BP control using monotherapy, fixed-dose olmesartan medoxomil/hydrochlorothiazide (HCTZ) [Olmetec plus, Benicar-HCT] combination therapy may be initiated 3.

Comparison with Other Antihypertensive Medications

  • Olmesartan medoxomil has been shown to be more effective than losartan, candesartan cilexetil, or irbesartan monotherapy in reducing blood pressure 3, 4.
  • Combination therapy with olmesartan medoxomil plus HCTZ was superior to that with benazepril plus amlodipine, as effective as that with losartan plus HCTZ, noninferior to that with atenolol plus HCTZ, but less effective than that with telmisartan plus HCTZ 3.
  • Olmesartan provides better antihypertensive efficacy than losartan and valsartan and has no association with an increased risk of adverse events in comparison with losartan, valsartan, candesartan, and irbesartan 4.

Benefits of Olmesartan Medoxomil

  • Olmesartan medoxomil has a favourable safety profile and low discontinuation rates 5.
  • It is effective in maintaining blood pressure stability over 24 hours 3, 5.
  • Olmesartan medoxomil may have beneficial effects beyond blood pressure control, including improvements in biomarkers of vascular function 6.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

4
Research

Antihypertensive effects of olmesartan compared with other angiotensin receptor blockers: a meta-analysis.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2012

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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