Nice new hypertension guidelines

Figure 2 Summary of antihypertensive drug treatment[3]. A: Angiotensin-converting enzyme inhibitor or low-cost angiotensin II receptor blocker (ARB)[1]; C: Calcium-channel blocker (CCB); D: Thiazide-like diuretic (1) Choose a low-cost ARB; (2) A CCB is preferred but consider a thiazide-like diuretic if a CCB is not tolerated or the person has oedema, evidence of heart failure or a high risk of heart failure; (3) Consider a low dose of spironolactone[4] or higher doses of a thiazide-like diuretic; (4) At the time of publication (August 2011), spironolactone did not have a UK marketing authorisation for this indication. Informed consent should be obtained and documented; and (5) Consider an α- or β-blocker if further diuretic therapy is not tolerated, or is contraindicated or ineffective.