Alsikiren, Remikiren

Direct Renin inhibitor

Significantly reduces the mean SBP and DBP. Acts directly on the required substrate. Prevent the formation of Ang I and Ang II.

Adverse events are associated with a higher dose of aliskirin, and include fatigue, dry coughing, headache, dizziness, and diarrhea.  Not currently in use.

CYP3A4

Thiazide Diuretics
Hydrochlorothiazide, Chlorothiazide

Diuretics

First-line therapy for hypertension. Most frequently prescribed drug for patients aged over 65 years with diabetes and gout.

Side effects include frequent urination and higher risk of sexual dysfunction.
Worsen renal function.

CYP3A4, CYP2C9

Enalapril, Lisinopril, Fosinopril, Benazopril

ACE Inhibitors

First-line therapy. Decreases arteriolar resistance and improves venous capacity, cardiac output, and stroke volume, while leading to increased excretion of sodium in the urine.

Common adverse effects are hyperkalemia, coughing, headache, fatigue, dizziness, nausea, and renal impairment, and they are not recommended during pregnancy.

CYP3A4

Metaprolol, Atenolol

Beta-Blockers

Decrease the workload on the heart and vasodilating blood vessels, leading to reduced forceful heartbeats.
Block the action of catecholamines.

Not suggested as a first-line treatment for hypertension due to adverse events like risk of stroke.
Not prescribed for people with asthma because they have a higher chance of increased muscle spasms in the lungs.

CYP2D6

Amlodipine, Felodipine, Nicardipine

Calcium Channel Blocker

Extra benefit of slowing your heart rate. No sedation or CNS effect. No adverse fetal effects.

Side effects include constipation, lower extremity edema.  Ischemic Heart disease and Hypotension

CYP3A4, CYP2D6

Losartan, Valsartan, Irbesartan

Angiotensin II Receptor Blocker

Causes vasodilation and prevents vasoconstriction.
Effective blood pressure control.

Renal Dysfunction

CYP11B2, CYP3A4, CYP2C9