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A recent review concluded that antihypertensive treatment reduced cardiovascular deaths and disease, but did not significantly reduce total death rates. [41] Two professional organizations have published guidelines for the management of hypertension in persons over 79 years old.
A systematic review of 63 trials with over 35,000 participants indicated β-blockers increased the risk of mortality, compared to other antihypertensive therapies. [15] They do, however, have an important role in the prevention of heart attacks in people who have already had a heart attack. [37]
For high blood pressure it is usually a first-line treatment. It is also used to prevent kidney problems in people with diabetes mellitus. [7] Lisinopril is taken orally (swallowed by mouth). [7] Full effect may take up to four weeks to occur. [7] Common side effects include headache, dizziness, feeling tired, cough, nausea, and rash. [7]
Although it must be used with caution in patients with impaired liver or kidney function, Metformin, a biguanide, has become the most commonly used agent for type 2 diabetes in children and teenagers. Among common diabetic drugs, Metformin is the only widely used oral drug that does not cause weight gain. [9]
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. [146] The prescription of antihypertensive medication for children with hypertension has limited evidence.
The lead compound from Actelion/Merck has entered phase II trials. One compound from Speedel, SPP635, has completed phase IIa. The results showed it was safe and well tolerated over a four-week period, and it reduced blood pressure by 9.8 to 17.9 mmHg. In 2008, SPP635 was continuing phase II development for hypertension in diabetic patients ...