Editing Hypertension (section)

===Medications===
Several classes of medications, collectively referred to as [[antihypertensive drug|antihypertensive medication]]s, are available for treating hypertension.

First-line medications for hypertension include [[Thiazide|thiazide-diuretics]], [[calcium channel blockers]], [[angiotensin converting enzyme inhibitor]]s (ACE inhibitors), and [[Angiotensin II receptor blocker|angiotensin receptor blockers]] (ARBs).<ref>{{cite journal | vauthors = Wright JM, Musini VM, Gill R | title = First-line drugs for hypertension | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 4 | pages = CD001841 | date = April 2018 | pmid = 29667175 | pmc = 6513559 | doi = 10.1002/14651858.CD001841.pub3 }}</ref><ref name=JNC8/> These medications may be used alone or in combination (ACE inhibitors and ARBs are not recommended for use together); the latter option may serve to minimize counter-regulatory mechanisms that act to restore blood pressure values to pre-treatment levels,<ref name=JNC8/><ref>{{cite journal | vauthors = Chen JM, Heran BS, Wright JM | title = Blood pressure lowering efficacy of diuretics as second-line therapy for primary hypertension | journal = The Cochrane Database of Systematic Reviews | issue = 4 | pages = CD007187 | date = October 2009 | pmid = 19821398 | doi = 10.1002/14651858.CD007187.pub2 | s2cid = 73993182 }}</ref> although the evidence for first-line combination therapy is not strong enough.<ref>{{cite journal | vauthors = Garjón J, Saiz LC, Azparren A, Gaminde I, Ariz MJ, Erviti J | title = First-line combination therapy versus first-line monotherapy for primary hypertension | journal = The Cochrane Database of Systematic Reviews | volume = 2 | issue = 2 | pages = CD010316 | date = February 2020 | pmid = 32026465 | pmc = 7002970 | doi = 10.1002/14651858.CD010316.pub3 | collaboration = Cochrane Hypertension Group }}</ref> Most people require more than one medication to control their hypertension.<ref name="Go2013"/> Medications for blood pressure control should be implemented by a stepped care approach when target levels are not reached.<ref name=":5"/> Withdrawal of such medications in the elderly can be considered by healthcare professionals, because there is no strong evidence of an effect on mortality, [[myocardial infarction]], or [[stroke]].<ref>{{cite journal | vauthors = Reeve E, Jordan V, Thompson W, Sawan M, Todd A, Gammie TM, Hopper I, Hilmer SN, Gnjidic D | display-authors = 6 | title = Withdrawal of antihypertensive drugs in older people | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 6 | pages = CD012572 | date = June 2020 | pmid = 32519776 | pmc = 7387859 | doi = 10.1002/14651858.CD012572.pub2 | collaboration = Cochrane Hypertension Group }}</ref>

Previously, [[beta-blockers]] such as [[atenolol]] were thought to have similar beneficial effects when used as first-line therapy for hypertension. However, a Cochrane review that included 13 trials found that the effects of beta-blockers are inferior to that of other antihypertensive medications in preventing cardiovascular disease.<ref>{{cite journal | vauthors = Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH | title = Beta-blockers for hypertension | journal = The Cochrane Database of Systematic Reviews | volume = 1 | pages = CD002003 | date = January 2017 | issue = 1 | pmid = 28107561 | pmc = 5369873 | doi = 10.1002/14651858.CD002003.pub5 }}</ref>

The prescription of antihypertensive medication for children with hypertension has limited evidence. There is limited evidence that compares it with a placebo and shows a modest effect on blood pressure in the short term. Administration of a higher dose did not reduce blood pressure more.<ref>{{cite journal | vauthors = Chaturvedi S, Lipszyc DH, Licht C, Craig JC, Parekh R | title = Pharmacological interventions for hypertension in children | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD008117 | date = February 2014 | pmid = 24488616 | doi = 10.1002/14651858.CD008117.pub2 | collaboration = Cochrane Hypertension Group | pmc = 11056235 }}</ref>