Newer Drug Choices in Hypertension Treatment

Hypertension (HTN) continues be a major health problem with considerable mortality and morbidity resulting from the resultant vascular complications.[1] There are two wellestablished strategies to lower blood pressure (BP): Lifestyle alterations and drug treatment. Meta-analysis of randomized controlled trials (RCTs) has shown that a 10 mm reduction in systolic BP (SBP) or a 5 mm reduction in diastolic BP (DBP) is associated with significant reduction in all major cardiovascular (CV) events, all-cause mortality, stoke, coronary events, and heart failure (HF).[1] There are well-established classes of drugs used in the treatment of HTN as per guidelines.[2,3] This review intends to discuss new drugs/choices which are now available for the treatment of HTN in our country. It is not intended to review the well-established compounds. Five groups of drugs, for example, angiotensin-converting enzyme inhibitors (ACEIs), aldosterone receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), and diuretics (thiazides and thiazide-like diuretics such as chlorthalidone and indapamide), are recommended based on proven ability to reduce BP, reduce CV events, and overall CV morbidity and mortality. There are some specific differences between various drug groups. BBs cause less stroke prevention, whereas less HF prevention is documented by CCBs. The new drug choices will be discussed in the following sections [Table 1]. 1. Blockers of the renin-angiotensin system 2. Newer BBs 3. Thirdand fourth-generation CCBs 4. Anti-aldosterone agents (aldosterone antagonists).