Core IM | Internal Medicine Podcast28 Juli

#213 Hypertension First-Line Medications Troubleshooting | Bread & Butter Series

Why can lower-dose combinations be more effective and better tolerated than maximizing one medication? How to troubleshoot common challenges such as amlodipine edema, gout, electrolyte abnormalities, and the patient who says they cannot tolerate anything? Why ACT (ARBs, Calcium Channel Blockers, Thiazides) is the preferred first-line framework, and how to personalize medication choices based on comorbidities and side effects.

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🔹Transcript and Shownotes

03:00 | Diagnosing Hypertension

04:10 | When to Start Combination Therapy Instead of Monotherapy

07:00 | Choosing First-Line Therapy Using the ACT Framework

13:23 | Why ARBs Are Often Preferred Over ACE Inhibitors

16:02 | Choosing the Right ARB: Candesartan vs Losartan

18:39 | Comparing Potency & Duration Across First-Line Antihypertensives

20:54 | Amlodipine Edema: Why It Happens and How to Fix It

23:54 | Thiazides: Practical Tips, Electrolyte Problems & Class-Killer Side Effects

29:33 | Managing Patients Who 'Can't Tolerate' Blood Pressure Medications

Tags: Hypertension Management, High Blood Pressure, Primary Care, Internal Medicine, Core IM

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