Abstract

ANTIHYPERTENSIVE DRUGS: A COMPREHENSIVE REVIEW OF MECHANISM, THERAPIES AND CLINICAL ADVANCES

Kaveri B. Godase*, Sandhya R. Kolekar, Dr. Amita B. Dongare

Abstract

This review summarizes current understanding of antihypertensive therapy: pathophysiology of arterial hypertension, pharmacologic drug classes (mechanism, indication, major drugs, adverse effect), guideline-based treatment strategies, management of special populations, and recent clinical advances including device therapies and novel drugs. We emphasize guideline-recommended approaches to initiation and targets, the rationale for combination therapy, and emerging therapies for resistant hypertension such as aldosterone- synthesis inhibitors and renal denervation – highlighting both promising results and important trial failure. Key references and guideline sources are provided for clinicians and researchers. Successful treatment of hypertension is possible with limited side effects given the availability of multiple antihypertensive drugs classes. This review describes the various pharmacological classes of antihypertensive drugs, under two major aspects: their mechanisms of action and side effects. The mechanism of action is analysed through a pharmacological approach, i.e. the molecular receptor targets, the various sites along the arterial system, and the extra-arterial sites of action, in order to better understand in which type of hypertension a given pharmacological class of antihypertensive drugs is most indicated. In addition, side effects are described and explained through their pharmacological mechanisms, in order to better understand their mechanism of occurrence and in which patients drugs are contra-indicated.

Keywords: Hypertension, Antihypertensive drugs, mechanisms, resistant hypertension, renal denervation, aldosterone synthase inhibitors, SGLT2 inhibitors, guidelines.