ABSTRACT
Hypertension is the level of blood pressure above which treatment does more good than harm. In mild uncomplicated hypertension at least four pairs of measurements should be made over a period of 3—6 months before drug treatment is introduced. Calcium-channel blockers are the drugs of first choice in the treatment of hypertension. However, patients with diabetes and hypertension often require multiple drug therapy, and blood pressure reduction is more important than the choice of the individual agent. Non-steroidal anti-inflammatory drugs blunt the anti-hypertensive effect of angiotensin-converting-enzyme inhibitorsand other antihypertensive agents, and the combination is particularly problematical in patients with chronic renal impairment. For the majority of patients, thiazide diuretics are preferred to loop diuretics, except in patients receiving large doses of vasodilator drugs, for whom long-acting or multiple short-acting loop diuretics are preferred. Prolonged use of loop diuretics can induce a hypokalaemic metabolic alkalosis.
