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. 2018 Nov 27;21(1):4–15. doi: 10.1111/jch.13426

Table 4.

Preferred and acceptable pharmacologic agents (in order of preference) within each drug class

Drug class Agent Preference Characteristics
ARB Azilsartan Preferred

Most potent ARB

Long duration of action

Telmisartan Preferred Long duration of action
Irbesartan Preferred Long duration of action
All other long‐acting ARBs (candesartan, valsartan) Acceptable
Losartan and olmesartan Non‐preferred

Losartan—shorter duration of action

Olmesartan—association with enteropathy

ACE‐I Lisinopril, ramipril, benazepril Preferred Long duration of action and widely available
All other long‐acting agents (perindopril, trandolapril, quinapril, fosinopril, ramipril, moexipril) Acceptable Long duration of action
Enalapril and captopril Non‐preferred Short duration of action
CCBS Amlodipine Preferred Solid evidence, long duration of action, and widely available
Other long‐acting, once‐daily dihydropyridines (nifedipine, felodipine, nisoldipine) Acceptable Long duration of action
Non‐dihydropyridines: verapamil and diltiazem Non‐preferred Less evidence and more complicated side‐effect profile
Diuretics Chlorthalidone Preferred

Long duration of action

Supported by evidence

Most potent thiazide‐like diuretic

Hydrochlorothiazide Acceptable Shorter duration of action, widely available
Indapamide Acceptable May be more costly, less widely available

ACE‐I, angiotensin‐converting enzyme inhibitors; ARB, angiotensin receptor blockers; CCB, calcium channel blockers.