Editorial

Angiotensin-Receptor Blockers for the Management of Hypertension: New Insights, New Challenges

Authors: Sandeep A. Saha, MD, FACP

Abstract

Hypertension affects about one-third of the adult United States population.1 Although multiple classes of antihypertensive agents are currently available, hypertension remains untreated or undertreated in a large proportion of persons in the US and worldwide.2 Reasons cited for this observation include physician inertia—failure in initiation of treatment or failure to titrate the dose of medication(s) to achieve target blood pressure (BP) levels, as well as patient nonadherence to therapy due to adverse drug reactions, onerous dosing schedules, inadequate knowledge, or lack of financial resources. Recent treatment guidelines have stressed the need for aggressive BP control to target levels for both short-term and long-term prevention of cardiovascular events. Recent evidence has also suggested that most patients with uncontrolled hypertension will need two or more drugs to achieve recommended BP targets, especially those with lower targets such as patients with diabetes mellitus, chronic kidney disease and established coronary artery disease. Combination therapy with agents with different mechanisms of action may improve patient adherence by reducing the incidence of side-effects, simplifying dosing schedules, and reducing out-of-pocket costs.3

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