Newer agents in the treatment of arterial hypertension1

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Many new effective pharmacologic agents have been developed and marketed over the last decade for the treatment of hypertension. A number of beta blocking agents are now available for use in combination with thiazide diuretics or as monotherapy in selected hypertensive patients. All of the beta blockers are effective antianginal agents and appear to decrease the rate of sudden death and myocardial infarction in the postinfarction period. Calcium channel blocking agents share the antianginal effects of the beta blockers and also appear to be useful antihypertensive agents, although they are not approved for the latter use at this time. Converting enzyme inhibitors have been utilized with increasing frequency, both in patients with renovascular and essential hypertension. These agents have become increasingly popular because of their relative freedom from many of the side effects associated with other classes of antihypertensive drugs. Several new central and peripherally acting sympatholytic agents have also been marketed, but they do not appear to differ significantly from the older agents of this class. These new drugs provide considerable versatility for the clinician who treats hypertensive patients, but they have not replaced the older drugs which have proved to be effective in the treatment of hypertension.