Which are commonly used first-line in essential hypertension?

Which are commonly used first-line in essential hypertension?

• A. ACE inhibitors used alone
• B. Beta-blockers used alone
• C. Thiazide diuretics and long-acting calcium channel blockers
• D. Nitrates only

Answer: (C)

Essential hypertension is managed first with medications that reliably lower blood pressure while balancing safety and tolerability. A thiazide diuretic lowers BP by reducing blood volume and, over time, decreasing vascular resistance; it also has strong, well-established cardiovascular outcome data. A long-acting calcium channel blocker relaxes arterial smooth muscle, providing steady, dose-friendly blood pressure control with good tolerability. Using these two classes together targets two different mechanisms—volume and vasoconstriction—making it a robust, commonly used initial strategy for many patients with uncomplicated hypertension. Starting with an ACE inhibitor or beta-blocker alone can be appropriate in certain situations, but they’re not as universally favored as the first-line duo in uncomplicated cases. Nitrates aren’t used as first-line therapy for hypertension, as they’re indicated for angina rather than blood pressure control.

Essential hypertension is managed first with medications that reliably lower blood pressure while balancing safety and tolerability. A thiazide diuretic lowers BP by reducing blood volume and, over time, decreasing vascular resistance; it also has strong, well-established cardiovascular outcome data. A long-acting calcium channel blocker relaxes arterial smooth muscle, providing steady, dose-friendly blood pressure control with good tolerability. Using these two classes together targets two different mechanisms—volume and vasoconstriction—making it a robust, commonly used initial strategy for many patients with uncomplicated hypertension.

Starting with an ACE inhibitor or beta-blocker alone can be appropriate in certain situations, but they’re not as universally favored as the first-line duo in uncomplicated cases. Nitrates aren’t used as first-line therapy for hypertension, as they’re indicated for angina rather than blood pressure control.