Dr. Md.

Zihad Hossain Talukder

DMF (DHAKA)
01719512150

*Hypertension*

*Check BP every Morning and Afternoon 7 days at Home.

Age Target BP level Catagory Systolic Diastolic Check HTN
Under 60 years <140/90 mmhg
Upper 60 years <150/90 mmhg Optimal <120 <80 Electrolyte HDL cholesterol
All Age with DM <140/90 mmhg Pre-HTN 120-139 80-89 Creatinine Chest-xray
CKD <130/80 mmhg Stage-1 140-159 90-99 ECG Ultrasonography
Stage-2 160-179 100-109 Blood urea
Stage-3 ≥180 ≥110 Blood glucose

Drug Class Condition Use Contraindication

Diuretics HF,ISH,Post MI Gout, Pregnancy ,
* Thiazide diuretics: Hydrochlorothiazide β- bloker (atenolol),
Hyperkalaemia
*Loop diuretics: Furosemide (Lasix) HF,Post MI Pregnancy
*Anti-Aldosterone : Spironolactone HF, Post MI RF, Hyperkalaemia
Furosemide + Spironolactone (Fusid Plus) HF, Post MI RF, Hyperkalaemia
Calcium Channel Blocker IHD ,MI, Asthma Heart Failure
*Long Acting (Dihydropyridine): Amlodipine ,Nifedipine Pregnancy (nifedipine)
*Non- Dihydropyridine : Diltiazem, Verapamil Angina Heart Failure
(Verapamil)Constipation
ACE inhibitor DM Type 1,HF,Asthma Pregnancy,
Post MI ,Proteinurea Hyperkalaemia
Ramipril, Enarapril, Lisinopril
Oedema
Angiotensin Receptor Blocker DM Type-2 ,HF,Asthma Pregnancy,
Losartan, Valsartan, Olmesarten Hyperkalaemia
β- Blocker HF,Post MI,IHD Asthma,Pregnancy
Atenolol,Bisoprolol,Labetalol,Carvedilol Bradycardia
Centrally Acting : Methyldopa Use Only Pregnancy
 Dr. Md. Zihad Hossain Talukder
DMF (DHAKA)
01719512150

*Treatment of Hypertension *
Step : 1
*If Patient Age Under 55 ACE inhibitor –
1. Enarapril (5.0-40) mg daily. Trade Name: Anapril (5,10mg)
2. Lisinopril (2.5-40) mg daily. Trade Name: Lipril (5,10mg)
3. Ramipril (2-8) mg daily. Trade Name: Peripril ( 2,4,8mg)
If not tolerate Angiotensin Receptor Blocker
1. Losartan (50-100) mg daily. Trade Name: Angilock (25,50mg)
2. Valsartan (40-320) mg daily. Trade Name: Valsartil (40,80,160mg)
3. Olmesarten (10-40) mg daily. Trade Name: Abetis (10,20,40mg )
*If Patient Age 55 Calcium Channel Blocker
1. Amlodipine (5-10) mg daily. Trade Name: Camlodin (5,10mg )
2. Nifedipine (30-90) mg daily. Trade Name: Nifecap (10 mg )

Combination Trade Name

 Amlodipine+ Olmesartan= ARB+CCB Bizoran/Camlosart (5/40mg)
 Amlodipine+ Valsartan= ARB+CCB Amlosartan (5/80mg)
 Amlodipine+ Atenelol= ARB+BB Fixocard/Amdocal Plus (5/50 mg)
 Hydrochlorothiazide + Bisoprolol = Diuretics +BB Bislol plus (2.5/6.25mg)
 Hydrochlorothiazide + Losartan = Diuretics + CCB Angilock Plus (50/12.5mg)
 Hydrochlorothiazide + Olmesartan = Diuretics + CCB Abetis Plus (12.5/20mg)

Step : 2
If not control Increased dose . Add drug ACEI +ARB+CCB
 Amlodipine+ Olmesartan= ARB+CCB Trade Name : Bizoran/Camlosart (5/40mg)
 Amlodipine+ Valsartan= ARB+CCB Trade Name : Amlosartan (5/80mg)
 Amlodipine+ Atenelol= ARB+BB Trade Name : Fixocard/Amdocal Plus (5/50 mg)

Step : 3
If not control Add drug ACEI +ARB+CCB +Diuretics

Hydrochlorothiazide + Bisoprolol = Diuretics +BB Trade Name : Bislol plus (2.5/6.25mg)

Hydrochlorothiazide + Losartan = Diuretics + CCB Trade Name: Angilock Plus (50/12.5mg)

Hydrochlorothiazide + Olmesartan = Diuretics + CCB Trade Name: Abetis Plus (12.5/20mg)