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For patients over the age of 55 and people of African or Caribbean origin of any age the recommended early (step 1) drug treatment is now a calcium channel blocker (CCB) rather than a diuretic.
Step 2 drug treatment is now recommended as a CCB plus an angiotensin converting enzyme inhibitor (ACEi) or angiotensin-II receptor blocker (ARB).
These changes do not mean that patients will necessarily have their medication altered. If patients are happy on their treatment and it is working, there is no need to change it. Newly diagnosed patients will however follow the new recommendations.
Possibly, the biggest change is the introduction of drug treatment for the over 80s. New evidence shows that even in this age-group, drug treatment does reduce heart attack, stroke, deaths and hospitalisation. Drug therapy will therefore now be available to people over the age of 80. In an ageing population this has to be a good thing and shows you are never too old to start treatment. The recommended treatment for the over 80s will be the same as that for those aged 55-80 taking into account any other conditions and the need for a gentle approach to treating this age-group.