antihypertensieve

An antihypertensive, or antihypertensieve agent, is a drug used to treat hypertension, the long‑term elevation of arterial blood pressure. The primary objective is to lower blood pressure to reduce the risk of cardiovascular events and organ damage. Antihypertensives can achieve this by reducing vascular resistance, decreasing blood volume, slowing heart rate, or diminishing myocardial contractility. They are selected based on the patient’s profile, coexisting conditions, and tolerance.

Major classes include diuretics (thiazide such as hydrochlorothiazide; loop like furosemide), inhibitors of the renin–angiotensin system (ACE inhibitors such as enalapril; ARBs such as losartan; and direct renin inhibitors like aliskiren), calcium channel blockers (dihydropyridines such as amlodipine; non‑dihydropyridines such as diltiazem), beta‑blockers (metoprolol), alpha‑blockers (doxazosin), centrally acting agents (clonidine, methyldopa), and vasodilators (hydralazine, minoxidil). Mineralocorticoid receptor antagonists (spironolactone, eplerenone) also play a role, particularly in resistant hypertension or heart failure.

Antihypertensives are used for essential hypertension and specific situations such as hypertensive emergencies (where IV vasodilators or nitroprusside may be used). In pregnancy, certain agents like methyldopa and labetalol are preferred. Common considerations include monitoring blood pressure and renal function, watching for electrolyte disturbances, and reviewing drug interactions (for example NSAIDs can reduce diuretic and ACE‑inhibitor effects; potassium‑sparing agents raise potassium levels).