Pharmacology and mechanism of action These two agents are no more “direct” than any of the other vasodilating drugs, but they differ from the others in that their actual mechanisms of action remain uncertain. For hydralazine, the mechanism by which it relaxes arterial smooth muscle is unknown. On the other hand, it is now known [...]
The decision to intervene with drug therapy is influenced mainly by the extent of blood pressure elevation, evidence of target-organ damage or other cardiovascular disease, and the presence of other cardiovascular risk factors. A classification with specific guidelines for initiating drug therapy based on these factors has been proposed. Some general recommendations for initial selection [...]
Choice of a starting drug in the treatment of hypertension has been discussed above. If this single agent is not sufficiently efficacious, consideration should be given to using two drugs at relatively low doses, rather than “pushing” the dose of a single drug and increasing the risk of adverse effects. At the higher dosage range, [...]
