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January 19, 1970

Mechanisms of Antihypertensive Drug Therapy

Author Affiliations

From Jefferson Medical College (Dr. Brest) and Hahnemann Medical College (Drs. Onesti, Swartz, Seller, Kim, and Chinitz), Philadelphia.

JAMA. 1970;211(3):480-484. doi:10.1001/jama.1970.03170030072011

Recognizing that most patients with moderate or severe elevation of diastolic blood pressure require a double or triple antihypertensive drug regimen and, also, that the presence of hypertensive complications further modifies drug selection, it is readily apparent that the therapist must be intimately familiar with the clinical pharmacology of these drugs, if he is to achieve the optimum result. The purpose of this communication is to review mechanisms of action and hemodynamic effects of the commonly employed antihypertensive drugs.

Orally Given Diuretics  Of the various groups of antihypertensive drugs, the diuretics for oral administration have the greatest overall clinical usefulness. Their therapeutic advantages may be summarized as follows: (1) they lower blood pressures with the patient in both the supine and erect positions, (2) the overall incidence of side reactions accompanying their usage is low, (3) their antihypertensive effects are maintained despite prolonged administration, and (4) the orally given diuretics