01585nas a2200193   4500000000100000008004100001653001700042653001900059653001300078653000900091653001400100653002100114100001500135700001600150245003600166300001100202490000800213520117000221       2003                            d10aHypertension10aBlood Pressure10aExercise10asalt10aDiuretics10aWeight Reduction1 aArnolda L.1 aChalmers J.00aLowering blood pressure in 2003  a306-120 v1793 a<p>
The foundation of treatment for patients with hypertension is ongoing use of lifestyle measures such as physical exercise, weight reduction, and salt restriction. There should be emphasis on reduction of total cardiovascular risk, including smoking cessation and achievement of goal blood pressures. There are now five classes of first-line blood-pressure-lowering drugs - diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and calcium antagonists. In most patients, the choice of drug will be guided by the clinical situation in the individual patient, including the presence of target organ damage, diabetes, established vascular or kidney disease, or other comorbidities. In the absence of such clinical indications, start drug therapy with a low-dose diuretic. Combination therapy will be needed in around two-thirds of patients, and a diuretic will normally form one element of most combinations, with the second or third drug coming from among the remaining four. Consider the use of fixed-dose combinations to improve adherence to therapy. Use long-acting, once-daily preparations. [References: 27]
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