As not all drugs from the same class have the same antihypertensive potency, their selection could potentially affect the probability of achieving BP control.
Hypertension (HTN) guidelines recommend antihypertensive drug classes, without detailing specific drugs. Īlthough some meta-analyses have been published, their ability to determine significant clinical differences among drugs was questioned, since they were restricted to certain pharmacological drugs, and no analyses of combinations were performed or they were performed as simple meta-analyses (i.e., adjusting for specific variables) all of which, made it difficult to generalize the results. Moreover, the results obtained with their use, as well as the variables associated with treatment response, differ. Therefore, the comparison of the relative antihypertensive effect of several drugs, or that of the most common combinations, is not well known. However, most of these trials have been performed comparing just 2 agents, 2 combinations, or 2 treatment strategies, and they are considerably heterogeneous, with noncomparable study populations with respect to age, sex, and ethnic group, baseline BP or dose. Thus, the different treatments have been validated by means of studies showing their antihypertensive efficacy.
Selection of antihypertensive drugs should be based on the knowledge of the drug's ability to reduce blood pressure (BP) levels, which is the main target factor to avoid cardiovascular complications in these patients.
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