SHOW / EPISODE

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

32m | Jul 28, 2026

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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šŸ”¹Transcript and Shownotes


03:00 | Diagnosing HypertensionĀ 

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

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

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

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

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

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

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

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


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



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