How do I incorporate the ALLHAT results into my clinical decision-making when my patient may be taking an agent other than a diuretic for their blood pressure control?
The results of ALLHAT indicate that a thiazide-type diuretic was well tolerated, effective in lowering blood pressure and superior in reducing clinical events when compared to amlodipine and lisinopril. This evidence together with their lower cost has led to the ALLHAT recommendation that thiazide-type diuretics should be preferred for first-step antihypertensive drug therapy. So, if your patient is already on a thiazide diuretic, have him/her stay on it. It is important also to acknowledge that clinical decisions should be based on each patient’s clinical condition and preferences. The patient’s clinical condition or co-morbidities may provide a compelling reason for the choice of a different agent that should be prescribed if indicated. Further, because a large proportion of the hypertensive population usually requires more than one drug for blood pressure control, it is reasonable to consider a diuretic for inclusion in multi-drug antihypertensive regimens.
Related Questions
- If the patients blood pressure does not tolerate the use of both ACE-Inhibitor/ARB and diuretic therapy, is there a preference as to which of the aforementioned can be solely prescribed?
- How do I incorporate the ALLHAT results into my clinical decision-making when my patient may be taking an agent other than a diuretic for their blood pressure control?
- Can you tell if a patient is taking their medications as prescribed from the quantitation results?
