From the Guidelines
For Islander patients, thiazide diuretics like chlorthalidone are a better initial choice than amlodipine due to their superior efficacy in preventing heart failure and stroke, as evidenced by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline 1. When considering alternatives to amlodipine for Islander patients, it's essential to take into account the patient's comorbid conditions and potential side effects.
- Thiazide diuretics, such as chlorthalidone, have been shown to be superior to calcium channel blockers like amlodipine in preventing heart failure and stroke, making them a better initial choice for Islander patients 1.
- Calcium channel blockers like diltiazem or verapamil may be more appropriate alternatives to amlodipine, as they may cause less peripheral edema in Pacific Islander populations.
- ACE inhibitors like lisinopril or ARBs such as losartan are also viable alternatives, but monitoring for cough with ACE inhibitors is crucial.
- The choice of medication should be individualized based on comorbidities, potential side effects, and patient-specific factors, as recommended by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline 1. The guideline suggests that thiazide diuretics, especially chlorthalidone, are the best initial choice for single-drug therapy in most patients, including Islander patients, due to their efficacy in preventing heart failure and stroke 1.
From the Research
Alternative to Amlodipine for Islander Patient
- Azilsartan can be considered as an alternative to amlodipine for the treatment of hypertension, as it has been shown to be effective in reducing blood pressure in various studies 2, 3.
- The combination of azilsartan and amlodipine has been found to be effective in reducing blood pressure, with a significant decrease in systolic and diastolic blood pressure compared to placebo plus amlodipine 4.
- Azilsartan has been compared to other angiotensin receptor blockers, such as telmisartan, and has been found to be non-inferior in terms of efficacy and safety 5.
- The use of azilsartan in combination with other antihypertensive agents, such as chlorthalidone, has also been found to be effective in reducing blood pressure 3.
Considerations for Islander Patient
- The patient's specific medical history, lifestyle, and preferences should be taken into account when considering alternative treatments to amlodipine.
- The potential for adverse effects, such as headache and diarrhea, should be considered when prescribing azilsartan 2, 3.
- The use of azilsartan in combination with other medications, such as amlodipine, should be carefully monitored to minimize the risk of adverse effects 4.
Available Combination Therapies
- Several combination therapies are available, including azilsartan and amlodipine, which can be considered as an alternative to amlodipine alone 6.
- Other combination therapies, such as azilsartan and chlorthalidone, may also be considered depending on the patient's specific needs and medical history 3.