Withholding Anti-Hypertensives

Anti-Hypertensive Drugs: The concern on whether anti-hypertensive's should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America.

There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure. The concern regarding the use of anti-hypertensive medication as a treatment procedure for hypertension has mainly been centered on the optimal choice of these agents. The other factors include the side effects of these drugs on a hypertensive patient, especially coughing.

While three categories of these drugs are linked with cough as a side effect, they have varying casual explanations though angiotensin-converting enzyme (ACE) inhibitors play a crucial role (Van Amburgh, 2011). The main objective for the use of anti-hypertensives in dialysis patients is to obtain and sustain an optimal blood pressure or lessen it by the least intrusive measures possible. While this is not usually easily achievable, anti-hypertensive medications or therapy should not be withheld in patients who are hypertensive because of various reasons.

First, the therapy should not be withheld because of the availability of a variety of effective anti-hypertensive agents or drugs (Henrich, 2012, p.300). In order to address the concerns regarding the optimal choice of these drugs and side effects, anti-hypertensive agents should be selected in consideration of any co-existing diseases, patient's demographic attributes, lifestyle, risk profile, and financial conditions.

The availability of an extensive number of effective anti-hypertensive agents imply that they should not be withheld but certain considerations should be made to promote their effectiveness in a patient's conditions and lessen major side effects during treatment. Secondly, these drugs have proven to be effective in treatment of hypertension based on the findings of numerous researchers. In early tests on the use of these agents on treatment of hypertension, they demonstrated a considerable decrease in stroke but a less evident reduction in cases of coronary heart disease.

However, recent studies involving the use of lower doses of newer agents and diuretics have shown a huge decline in incidence of coronary heart disease (Kaplan, Bakris & Forman, 2013). Therefore, anti-hypertensive agents and statins have beneficial actions, which imply that they should not be withheld in patients with hypertension. Third, these drugs should not be withheld because such measures sometimes worsen co-existing diseases like orthostatic hypotension.

While there is a common notion that lessening and controlling blood pressure through the use of anti-hypertensive drugs may aggravate orthostatic hypotension, existing data do not support this conventional belief (Shibao, Lipsitz & Biaggioni, 2013, p.152). Recent studies have indicated that withholding such medication actually worsen these conditions. Therefore, rather than withholding the drugs for hypertensive patients, anti-hypertensive agents should be used but administered judiciously. References: Axon, R.N., Nietert, P.J.