Milestones in Antihypertensive Drug Treatment

Abstract

Hypertension provoked since the beginning of the 19th century a medical debate between physicians. The early antihypertensive agents were poorly tolerated. Progress towards more effective drugs, appeared after the 2nd World War. Thiocyanates, dehydrogenated alkaloids of ergot, barbiturates, bismuth and bromides, were soon replaced by phenoxbenzamine, hexamethonium, pentolinium, and mecamylamine. Thiazide diuretics were the biggest breakthrough during the early 1960's. Then Beta(beta)-blockers and angiotensin-converting enzyme inhibitors heralded a new era, until 1995, when losartan, the first non-peptide anti-hypertensive drug, was introduced. The plethora of the antihypertensive drugs changed the relationship between physicians and patients, pushed medicine towards prevention, and altered the medical marketing forever.