Definition of high blood pressure
What to do in case of hypertension?
For a better understanding of blood pressure The follow-up of a high blood pressure
High blood pressure damage High blood pressure and special cases
Why does high blood pressure exist? The self-measurement of blood pressure
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VI - What to do in case of a high blood pressure

6.1 - First of all, to eliminate a false high blood pressure
6.2 - To eliminate an obvious cause responsible for a high blood pressure
6.3 - To start a treatment without drug: life style modifications
6.4 - According to the circumstances, to treat by using drugs
6.5 - Anti-hypertensive therapy
6.6 - Why does the doctor prescribe a given anti-hypertensive drug and not another? The choice of the first treatment.

6.6 Why do physicians prescribe a given antihypertensive drug and not another? The choice of the first drug

Usually, the treatment of a high blood pressure always begins with the prescription of only one drug or an association with a slightly proportioned diuretic drug (in only one tablet).

The factors entering into account for the choice of the first antihypertensive therapy are related to the patient and the tolerance of the drug.

6.6.1- The elements to be taken into account concerning the patient are:


- His age, because of the possible appearance of a renal insufficiency and of the deterioration of the blood pressure regulation which can be responsible for an arterial hypotension;

- The existence of a renal insufficiency encourages the physician to prescribe an angiotensin-converting enzyme inhibitor or an angiotensine receptor antagonist, by introducing them gradually and by supervising the renal function with very regular blood tests. The diuretics, apart from the soludactone, can be used first.

Nevertheless other antihypertensive drugs can be prescribed by checking the adaptation of the quantity of drug according to the renal biological test (dosage of creatinine).

- The existence of a diabetes is very important to consider because the antihypertensive drugs of the family of the angiotensin-converting enzyme inhibitor are prescribed first, if there is no renal insufficiency.

- If the subject has already presented a myocardial infarction or presents an angina pectoris, a treatment by beta-adrenoreceptor blocking drugs or an angiotensin-converting enzyme inhibitor will be prescribed first.

- In the event of cardiac insufficiency, the physician prescribes an angiotensin-converting enzyme inhibitor.

6.6.2- Elements related to the drug

The patient with a high blood pressure must tolerate his drug well, because the treatment of the high blood pressure is very long.

Thus, the physician prescribes the best drug for his patient, having an effectiveness 24 hours a day, and compatible with the other treatments taken by his patient.

File last reviewed on : 18 dec 2011


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