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For those over 55, they suggest starting with a Calcium channel inhibitor or a Diruretic first, and if the target lower blood pressure is not reached, to use an ACE Inhibitor (or an Angiotensin receptor blocker) or a Beta blocker in addition.

For black patients they recommend using the same protocol as suggested for those over 55, regardless of patient's age, as the 'C and D' drugs are more effective on older people and in the black population than 'A and B' drugs. This is because older people and black people have less natural renin than non-black (white and asian) and younger people, and C and D drugs work better than A and B where renin levels are low.

The BHS guidelines were last revised in 1999. Specialists in the field representing over 12 different stakeholder organisations including the British Hearth Foundation, the Royal College of General Practitioners and the UK Department of Health contributed to the latest guidelines.

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Contact: Tony Stephenson
at.stephenson@imperial.ac.uk
44-207-594-6712
Imperial College London
12-Mar-2004