PubMed · 3072181
A modern plan for treating hypertension.
Abstract
Essential hypertension is a heterogeneous spectrum of pathophysiologic disturbances, not a single entity. Identification and characterization of two different vasoconstrictor mechanisms--one renin-mediated, the other sodium-volume mediated--has made it possible not only to apply antihypertensive drug therapy on a more rational basis but to screen out a significant number of cases of curable (high-renin) renovascular disease as well as many cases of curable (low-renin) primary aldosteronism. An array of five major drug types makes long-term monotherapy for essential hypertension an achievable goal. Converting enzyme inhibitors and beta-blockers counteract the renin-mediated vasoconstriction; diuretics, calcium-channel antagonists, and alpha-blockers oppose the low-renin sodium-volume-mediated form of vasoconstriction. This information brings us closer to the primary goal of modern therapy: to give each patient the fewest drugs in the smallest amounts and with the least frequency possible for the often lifetime commitment that antihypertensive therapy involves.
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J H Laragh. 1988. A modern plan for treating hypertension.. https://doi.org/10.1037/h0090277
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