What are the common drug classes, including their brand names, used in managing hypertension, hyperlipidemia, and heart failure?

Common Drug Classes and Brand Names for Hypertension, Hyperlipidemia, and Heart Failure

The most effective management of hypertension, hyperlipidemia, and heart failure requires knowledge of specific drug classes and their brand names to optimize treatment outcomes and reduce mortality and morbidity.

Hypertension Medications

Angiotensin-Converting Enzyme (ACE) Inhibitors

• Lisinopril (Prinivil, Zestril) 1, 2
• Enalapril (Vasotec) 1, 2
• Captopril (Capoten) 1
• Ramipril (Altace) 1
• Fosinopril (Monopril) 1
• Quinapril (Accupril) 1
• Perindopril (Aceon) 1
• Trandolapril (Mavik) 1

Angiotensin II Receptor Blockers (ARBs)

• Losartan (Cozaar) 1, 3
• Valsartan (Diovan) 1
• Candesartan (Atacand) 1

Calcium Channel Blockers (CCBs)

• Dihydropyridine CCBs: Amlodipine (Norvasc), Nifedipine (Procardia, Adalat) 1
• Non-dihydropyridine CCBs: Diltiazem (Cardizem, Tiazac), Verapamil (Calan, Verelan) 1

Diuretics

• Thiazide and thiazide-like: Hydrochlorothiazide (Microzide), Chlorthalidone (Thalitone), Indapamide (Lozol) 1
• Loop diuretics: Furosemide (Lasix), Torsemide (Demadex), Bumetanide (Bumex) 1
• Potassium-sparing: Spironolactone (Aldactone), Eplerenone (Inspra), Amiloride (Midamor) 1

Beta-Blockers

• Metoprolol succinate (Toprol XL) 1
• Carvedilol (Coreg) 1
• Bisoprolol (Zebeta) 1
• Nebivolol (Bystolic) 1

Other Antihypertensives

• Alpha-blockers: Doxazosin (Cardura), Prazosin (Minipress) 1
• Central-acting agents: Clonidine (Catapres) 1
• Direct vasodilators: Hydralazine (Apresoline) 1

Hyperlipidemia Medications

Statins (HMG-CoA Reductase Inhibitors)

• Atorvastatin (Lipitor) 1
• Rosuvastatin (Crestor) 1
• Simvastatin (Zocor) 1
• Pravastatin (Pravachol) 1
• Lovastatin (Mevacor) 1
• Fluvastatin (Lescol) 1
• Pitavastatin (Livalo) 1

Other Lipid-Lowering Agents

• Fibrates: Fenofibrate (Tricor, Fenoglide), Gemfibrozil (Lopid) 1
• Bile acid sequestrants: Cholestyramine (Questran), Colesevelam (Welchol) 1
• Cholesterol absorption inhibitors: Ezetimibe (Zetia) 1
• PCSK9 inhibitors: Evolocumab (Repatha), Alirocumab (Praluent) 1
• Nicotinic acid: Niacin (Niaspan) 1

Heart Failure Medications

ACE Inhibitors

• Same as listed under hypertension - critical first-line therapy for heart failure with reduced ejection fraction (HFrEF) 1

ARBs

• Same as listed under hypertension - alternative when ACE inhibitors are not tolerated 1

Beta-Blockers

• Specifically for heart failure: Metoprolol succinate (Toprol XL), Carvedilol (Coreg), Bisoprolol (Zebeta) 1

Mineralocorticoid Receptor Antagonists (MRAs)

• Spironolactone (Aldactone) 1
• Eplerenone (Inspra) 1

Angiotensin Receptor-Neprilysin Inhibitor (ARNI)

• Sacubitril/Valsartan (Entresto) 1

If Channel Inhibitor

• Ivabradine (Corlanor) 1

Diuretics

• Loop diuretics: Furosemide (Lasix), Torsemide (Demadex), Bumetanide (Bumex) - primary agents for congestion relief 1

Vasodilators

• Hydralazine and Isosorbide Dinitrate (BiDil) - particularly beneficial in African American patients 1

SGLT2 Inhibitors

• Dapagliflozin (Farxiga), Empagliflozin (Jardiance) - newer agents with proven cardiovascular benefits 1

Special Considerations

Combination Therapies

• Fixed-dose combinations are available for improved adherence: Lisinopril/Hydrochlorothiazide (Zestoretic), Amlodipine/Benazepril (Lotrel), Valsartan/Hydrochlorothiazide (Diovan HCT) 1

Medication Selection Based on Comorbidities

• For patients with both hypertension and heart failure: ACE inhibitors, ARBs, beta-blockers, and MRAs are preferred 1, 4
• For patients with diabetes and hypertension: ACE inhibitors, ARBs, and SGLT2 inhibitors offer additional benefits 1
• For patients with chronic kidney disease: ACE inhibitors and ARBs are preferred for their renoprotective effects 1

Bioequivalence Considerations

• Generic medications are bioequivalent to brand-name drugs and can be equally effective while being more cost-effective 5, 6
• When switching between brand and generic formulations, monitoring for therapeutic efficacy is recommended 7

Medication Titration

• For heart failure medications, gradual uptitration to target doses is recommended to achieve maximum mortality benefits 1, 3
• For example, losartan should be titrated from 50 mg to 100 mg daily to achieve optimal outcomes 3

Contraindications and Precautions

• ACE inhibitors and ARBs should not be used in combination due to increased risk of hyperkalemia and renal dysfunction 2
• NSAIDs should be avoided in heart failure patients as they may diminish the effects of ACE inhibitors and diuretics 2
• Calcium channel blockers (except amlodipine and felodipine) are generally contraindicated in heart failure with reduced ejection fraction 1