| Class | Indicated | Contraindicated |
|---|---|---|
| Diuretics Thiazide, Thizide-like: HCT, Xipamid Loop Diuretics: Furosemid |
Cardiac Insufficiency Osteoporosis |
Diabetes mellitus Gicht Metabolic Syndrome Hypopotassemia Pregnancy |
| ACEi Angiotensin Coverting Enzyme Inhibitor Enalapril, Ramipril |
Diabetes mellitus (Nephroprotective) Cardiac Insufficiency Left Ventricular Hypertrophy Arteriosclerosis Atrial Fibrillation after Myocardial Infarct Yound Age Metabolic Syndrome |
Renal Failure Hyperpotassemia Pregnancy Cardiac Valvular Stenosis |
| ARB Angiotensin I Receptor Blocker Candesartan, Valsartan |
– ·· – | – ·· – |
| CCB Calcium Channel Blocker Dihydropyridine (DHP): Amlodipin Non-Dihydropyridine (NDHP): Verapamil, Diltiazem |
Peripheral Artery Disease Stable Angina Metabolic Syndrome Raynaud Syndrome Prinzmetal Angina Achalasia |
Cardiac Insufficiency Unstable Angina Actue Myocardial Infarct Bradycardic Arrhzthmia GERD Pregnancy |
| Beta-Blocker Metoprolol, Bisoprolo |
Coronary Heart Disease after Myocardial Infarct Cardiac Insufficiency Tachycardic Arrhythmia Pregnancy |
Bradycardic Arrhythmia Peripheral Artery Disease Diabetes mellitus Metabolic Syndrome Asthma Raynaud Syndrome |
| MRA Mineralocorticoid Receptor Antagonists Spironolacton, Eplerenon |
Resistant Hypertension Left Ventricular Hypertrophy |
Renal Insufficiency Hepatic Failure Hypepotassemia Pregnancy |
| Steps | Therapy |
|---|---|
| 0 | Monotherapy if systolic BP < 150 mmHg |
| 1 | Dualtherapy ACEi/ARB + CCB/Diuretic |
| 2 | Trippletherapy ACEi/ARB + CCB + Diuretic |
| 3 | Tripple Therapy + Spironolacton (25 – 50 mg)/Diuretic/Alpha-Blocker/Beta-Blocker |
| Steps | Therapy |
|---|---|
| 0 | Monotherapy if systolic BP < 150 mmHg |
| 1 | ACEi/ARB + Beta-Blocker/CCB OR CCB + Diuretic/Beta-Blocker OR Betablocker + Diuretica |
| 2 | Tripple Therapy |
| 3 | Tripple Therapy + Spironolacton (25 – 50 mg)/Diuretic/Alpha-Blocker/Beta-Blocker |
| Steps | Therapy |
|---|---|
| 1 | ACEi/ARB + CCB OR ACEi/ARB + Diuretics/Loop Diuretics [1] |
| 2 | Trippletherapy ACEi/ARB + CCB + Diuretics/Loop Diuretics [1] |
| 3 | Tripple Therapie + Spironolacton (25 – 50 mg)/Diuretic/Alpha-Blocker/Beta-Blocker |
| Steps | Therapy |
|---|---|
| Initial | ACEi/ARB + Diuretics/Loop Diuretics [1] + Beta-Blocker |
| 2 | ACEi/ARB + Diuretics/Loop Diuretics [1] + Beta-Blocker + MRA |
| Steps | Therapy |
|---|---|
| Initial | ACEi/ARB + Beta-Blocker/NDHP-CCB [2] OR Betablocker + CCB |
| 2 | ACEi/ARB + Beta-Blocker + DHP-CCB/Diuretics OR Beta-Blocker + DHP-CCB + Diuretics |
- Loop Diuretics are indicated when GFR < 30 ml/min/1.72 m2
- Combination of Beta-Blockers with NDHP-CCB is not recommended because of potential for significant reduction in Heart Rate.