One medication is started at a low dose and titrated upward slowly until desired effects are reached. Use of a medication with a once-daily dosage schedule increases patient compliance. If needed, a second medication from another class is added. Often, smaller doses of two different medications can be more effective than a large dose of one. If a diuretic wasn't used first, it should be the second added.
Many patients require multiple-drug therapy to control their hypertension.
After hypertension has been adequately controlled for at least one year, a trial of decreasing medication doses should be attempted. This will be especially effective if lifestyle modifications have been successfully undertaken. Ethnicity and age should be considered in selecting a medication. A brief discussion of anti-hypertensive medication follows. The reader should refer to a drug handbook for details about dosage and side effects.