| Drug | Class | Adult | Paediatric | Notes |
|---|---|---|---|---|
| Telmisartan or losartan[1] | Angiotensin receptor blocker (ARB) | Telmisartan 40–80 mg PO daily; losartan 50–100 mg PO daily | — | First-line in HTN with diabetes especially with albuminuria; renal and cardiovascular protection beyond BP lowering |
| Enalapril or ramipril (alternative ACE-i)[1] | ACE inhibitor | Enalapril 5–40 mg PO daily; ramipril 2.5–10 mg PO daily | — | Alternative first-line; switch to ARB if dry cough develops |
| Amlodipine[1] | Calcium channel blocker (DHP) | 5–10 mg PO once daily | — | Add when BP not at target on RAAS blockade alone; combines well with ARB/ACE-i |
| Indapamide or chlorthalidone[1] | Thiazide-like diuretic | Indapamide 1.5 mg sustained-release once daily; chlorthalidone 12.5–25 mg PO daily | — | Third agent when dual therapy insufficient; preferred over hydrochlorothiazide for cardiovascular outcomes |
| Spironolactone (resistant HTN in DM)[1] | Mineralocorticoid receptor antagonist | 12.5–25 mg PO once daily | — | Fourth-line per PATHWAY-2; monitor K+ closely especially with concurrent ACE-i/ARB |
| Empagliflozin or dapagliflozin (cardio-renal protection)[1] | SGLT2 inhibitor | 10 mg PO once daily (empagliflozin up to 25 mg) | — | Modest BP reduction plus cardiovascular and renal protection independent of glycaemic effect |
Blood pressure targets and pharmacotherapy in adults with diabetes and hypertension; ACE-i/ARB-anchored therapy with attention to renal and CV protection.