Pitfalls in the pharmacotherapy of hypertension.

Abstract

Despite the widespread availability of effective antihypertensive medications, blood pressure control remains unsatisfactory in a large number of patients, often due to avoidable dosing misconceptions rather than actual treatment resistance. This educational review aims to facilitate continuing medical education and clinical practice by exploring existing challenges in the pharmacological management of hypertension, focusing on the common drugs prescribed to manage hypertension. After reading this article, clinicians should be able recognise non-linear dose-response relationships, select appropriate medications and doses to achieve better blood pressure control, improve compliance alongside managing side effects that have led to premature discontinuation of beneficial medications. The review further explores how pharmacokinetic properties and patient-specific considerations, such as renal function and ethnicity, might influence choice of antihypertensive medications. This article aims to strengthen clinical choice, medication adherence and long-term management of blood pressure. Copyright © 2026 The Authors. Published by Elsevier Ltd on behalf of Royal College of Physicians. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/