Md Amjad Noor and Saleem Ahmad
Due to its increased risk of heart failure, myocardial infarction, and stroke, hypertension is a significant risk factor for premature death. Antihypertensive medications can lower cardiovascular (CV) morbidity and death. To achieve blood pressure (BP) goals, the majority of hypertensive individuals require more than one antihypertensive medication. Only 20% to 40% of people respond well to monotherapy when trying to lower their blood pressure. The pathophysiology of hypertension is mediated by a number of factors, such as elevated peripheral vascular resistance, elevated cardiac effort, and hypervolemia. Multiple mechanisms can be targeted for increased BP reduction. Because the underlying mechanism causing the BP increase is either different or was previously treated with the lower dose, increasing the dose of a single medication frequently does not have the desired BP-lowering effect. In addition, medications that target various pathways may work to reduce blood pressure. The renin-angiotensinaldosterone system is known to be enhanced by the effects of diuretics and to become active as a response to the decreased circulating blood volume. The renin-angiotensin-aldosterone system is elevated, therefore by combining a diuretic with a renin-angiotensin aldosterone system blocker; blood pressure may be reduced more successfully. If possible side effects of a drug's are vary on dosage, maximum dose may also be effective to reduced B P. Renin-angiotensin-aldosterone system blockers can be added to calcium channel blockers (CCBs) by vein dilation to decrease the occurrence of peripheral oedema that is associated with higher dosages of CCBs. This combination is a potential therapy for the management of hypertension due to the efficiency of enalapril and lercanidipine in lowering blood pressure, the safety profile, and the usage of CCBs and ACE inhibitors together in clinical studies with excellent CV hard end point outcomes.
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