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Do I Increase the Dose or Augment the Antihypertensive Medication?

Hypertension management can get a little overwhelming sometimes since there are so many medications to choose from.  We often use multiple medications with different mechanisms of action to treat hypertension.

If a patient is already on a medication at a moderate or low dose, what should we do if blood pressure remains elevated?  I’m going to give you some ideas to think about here with the advantages and disadvantages of increasing the dose or adding another agent.

Advantages of adding another agent

  • Be able to cover compelling indications
  • Avoid higher doses of each agent which may reduce incidence of dose dependent side effects
  • Targeting different mechanisms of hypertension may help provide a better response

Disadvantages of adding another agent

  • Complicate patient adherence and patient quality of life with more pills (exception here might be combination meds)
  • More side effect profiles to monitor/potential for drug interactions
  • More expense to the patient

What else do you consider when looking at hypertension medications?

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Written By Eric Christianson

April 30, 2017

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