Initial treatment of mild hypertension with diet and exercise, followed by a diuretic or beta-blocker, is recommended to reduce stroke and cardiovascular morbidity and mortality.
What is the appropriate initial therapy for patients with mild hypertension?
Summarizes the JNC 5 recommendations for initial hypertension therapy, emphasizing lifestyle changes followed by diuretics or beta-blockers.
Hypertension is one of the most common conditions treated by the clinician, yet accurate diagnosis and selection of the appropriate treatment can be challenging and recommendations regarding antihypertensive medications continue to evolve. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure recommends diet and exercise for the initial treatment of mild hypertension, followed by a diuretic or beta-blocker if necessary, unless contraindicated. This recommendation is based on outcome studies using these drugs that demonstrate reductions in major diseases that treatment of hypertension is intended to prevent: stroke and cardiovascular morbidity and mortality. Other antihypertensive drugs, while not tested in large trials evaluating outcomes, have unique advantages for certain patients. Consideration of the patient's medical conditions and needs, including the cost of medication, is essential to ensuring optimal treatment of hypertension.
Norman M. Kaplan (1996) conducted a review in Hypertension. Antihypertensive therapy was evaluated. Initial treatment of mild hypertension with diet and exercise, followed by a diuretic or beta-blocker, is recommended to reduce stroke and cardiovascular morbidity and mortality.