What classes of antihypertensive drugs are most commonly used to treat patients with CKD and CV disease prevention?
For CV disease prevention in those with high BP, ACEi and ARBs, CCBs, and thiazide-like diuretics are the most commonly used classes of antihypertensive drugs. If a 3-drug combination of RASi, CCB, and diuretic at recommended doses is not adequate to control BP, additional therapy including a mineralocorticoid-receptor antagonist (MRA), long-acting alpha antagonist, or beta-blocker can be used, as well as dihydralazine, hydralazine, minoxidil, or centrally acting agents.171 Higher BP due to fluid overload is common in CKD; therefore, diuretics are, in general, logical agents at appropriate dose to lower high BP, with or without the concomitant use of RASi.