Table 1: Compelling and possible indications and contraindications for major classes of antihypertensive drugs (Adapted from Reference 12)

  Indications   Contraindications  
Class of drug Compelling Possible Possible Compelling
ACE inhibitors
Heart failure
Left ventricular dysfunction post-myocardial infarction or established coronary heart disease
Type 1 diabetic nephropathy
Secondary stroke prevention
Chronic renal disease
Type 2 diabetic nephropathy
Proteinuria renal disease
Renal impairment
Peripheral vascular disease
Pregnancy
Renovascular disease
Angiotensin II receptor blockers
Angiotensin converting enzyme inhibitor intolerance
Type 2 diabetic nephropathy
Hypertension with left ventricular hypertrophy
Heart failure in angiotensin converting enzyma intolerant patients, after myocardial infarction
Left ventricular dysfunction after myocardial infarction
Intolerance of other antihypertensive drugs
Proteinuria renal disease, chronic renal disease
Heart failure
Renal impairment
Peripheral vascular disease
Pregnancy
Renovascular disease
Calcium channel blockers (dihydropyridine)
Elderly patient isolated systolic hypertension
Angina
-
-
Calcium channel blockers (rate limiting)
Angina
Elderly patient
Combination with blockade
Heart block, heart failure
Thiazides or thiazide-like diuretics
Elderly patient, isolated systolic hypertion, heart failure, secondary stroke prevention
-
-
Gout
Blockers
Myocardial infarction, angina
Heart failure
Heart failure
Peripheral vascular disease
Diabetes (except with coronary heart disease)
Asthma or chronic obstructive pulmonary disease
Heart block
Blockers
Benign prostatic hypertrophy
-
Postural hypotension, heart failure
Urinary incontinence