A patient with mild to moderate hypertension may have few if any symptoms. Adverse effects caused by antihypertensive medications may have a much greater negative impact on the patient's quality of life.

Adverse effects of antihypertensive drugs may include:

(1) asthenia, fatigue and/or lethargy

(2) sexual dysfunction, especially erectile dysfunction in the male

(3) disturbed sleep (insomnia, nightmares, etc)

(4) headache

(5) dry mouth

(6) dizziness

(7) nausea

(8) myalgia or muscle cramps

(9) anxiety, depression or emotional lability

(10) change in heart rate (bradycardia, tachycardia, palpitations)

(11) swelling of feet and ankles

(12) polyuria

(13) hives

(14) change in bowel habits (diarrhea, constipation)

(15) visual disturbances

(16) cognitive impairment

(17) difficulty walking, especially in the elderly

(18) cough or bronchospasm


It may be difficult to convince a patient to be compliant with a chronic drug regimen that causes significant distress.


The goals of antihypertensive therapy should include:

(1) patient education on the long-term need for therapy

(2) selection of the regimen that is both efficacious and tolerable

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