What is the recommended treatment for hypertension?

From the Guidelines

The recommended treatment for hypertension involves lifestyle modifications and medication therapy, with a focus on achieving a target blood pressure below 130/80 mmHg, as recommended by the most recent guidelines 1. The treatment approach should prioritize lifestyle changes, including reducing sodium intake to less than 2,300 mg daily, following the DASH diet, regular physical activity, limiting alcohol consumption, maintaining a healthy weight, and quitting smoking. If blood pressure remains elevated despite these measures, medications are prescribed based on individual factors. First-line medications include:

• Thiazide diuretics (like hydrochlorothiazide 12.5-25 mg daily)
• ACE inhibitors (such as lisinopril 10-40 mg daily)
• Angiotensin II receptor blockers (like losartan 50-100 mg daily)
• Calcium channel blockers (such as amlodipine 5-10 mg daily) Many patients require multiple medications to achieve the target blood pressure, and initiation of antihypertensive drug therapy with 2 first-line agents of different classes is recommended in adults with stage 2 hypertension and an average BP more than 20/10 mm Hg above their BP target 1. Regular monitoring is essential to assess medication effectiveness and adjust treatment as needed, with consideration of the patient's individual risk factors and comorbidities, as outlined in the guidelines 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. Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits

The recommended treatment for hypertension is to lower blood pressure using antihypertensive drugs from a variety of pharmacologic classes, such as losartan 2 or lisinopril 3.

• 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 choice of therapy may be guided by considerations such as the presence of diabetes or hyperlipidemia, and the need for additional approved indications and effects.

From the Research

Treatment of Hypertension

The recommended treatment for hypertension includes lifestyle modifications and pharmacologic therapy.

• Lifestyle modifications are considered first-line therapy and include:
  • Weight loss
  • Healthy dietary pattern with low sodium and high potassium intake
  • Physical activity
  • Moderation or elimination of alcohol consumption 4, 5, 6
• Pharmacologic therapy is initiated based on the level of blood pressure and the presence of high atherosclerotic cardiovascular disease risk.
• First-line drug therapy for hypertension consists of:
  • Thiazide or thiazide-like diuretics
  • Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers
  • Calcium channel blockers 4, 7, 8

Blood Pressure Targets

• The target blood pressure for most adults is less than 130/80 mm Hg 4, 7
• For adults 65 years and older, the target systolic blood pressure is less than 130 mm Hg 4

Benefits of Treatment

• Reducing blood pressure can decrease the risk of cardiovascular disease events by approximately 20% to 30% for every 10 mm Hg reduction in systolic blood pressure 4
• Lifestyle modifications and pharmacologic therapy can improve blood pressure control and reduce the risk of cardiovascular disease morbidity and mortality 4, 7, 5, 6, 8