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

From Core IM | Internal Medicine Podcast by Core IM Team

July 28, 2026 · 33 min

About this episode

This episode discusses troubleshooting first-line hypertension medications and the benefits of lower-dose combinations.

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. 🔹 Sponsor: Oakstone CME Use the code "CORE25" for 25% off: https://www.coreimpodcast.com/MKSAP 🔹 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…

People in this episode

Host: Core IM Team

Topics covered

Hypertension Management
First-Line Medications
Combination Therapy
Patient Tolerance
Electrolyte Abnormalities
Internal Medicine

Keywords

Hypertension
Amlodipine Edema
Gout
Electrolyte Problems
ARB
Calcium Channel Blockers
Thiazides
Primary Care
Internal Medicine

Mentioned in this episode

Products: MKSAP

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