Indapamide

Indapamide is an indole-derivative thiazide-like chlorosulfamoyl diuretic and arterial vasodilator on the WHO Model List of Essential Medicines. At antihypertensive doses, it exhibits a dual mechanism: direct vascular action (stimulating prostaglandin PGE2 synthesis and blocking calcium influx in vascular smooth muscle to reduce peripheral resistance) combined with mild distal tubular natriuresis, exerting virtually neutral effects on lipids and glucose. Indicated for essential hypertension, alone or in fixed-dose combination with ACE inhibitors (perindopril) or CCBs.

Angiotensin Converting Enzyme (ACE) Inhibitor on the WHO Model List of Essential Medicines. It blocks the conversion of angiotensin I to the potent vasoconstrictor angiotensin II, reducing peripheral arterial resistance, decreasing aldosterone secretion, and inhibiting the enzymatic degradation of bradykinin, producing potent vasodilation and cardioprotection. Indicated for essential hypertension, heart failure with reduced ejection fraction (HFrEF), post-myocardial infarction, and diabetic nephropathy.

Amlodipine (or S-Amlodipine, the pure chirally active enantiomer with lower incidence of ankle edema) is a third-generation dihydropyridine calcium channel blocker on the WHO Model List of Essential Medicines. It inhibits transmembrane influx of extracellular calcium ions into vascular smooth muscle and cardiac muscle through L-type channels, resulting in potent peripheral arterial and coronary vasodilation with an exceptionally long half-life (30-50 hours). Indicated for essential hypertension, chronic stable angina pectoris, and vasospastic (Prinzmetal's) angina.

Beta-adrenergic receptor antagonist (cardioselective beta-1 blocker, non-selective beta blocker, or third-generation vasodilating beta-blocker with alpha-blockade or nitric oxide release) on the WHO Model List of Essential Medicines. It competitively blocks adrenergic stimulation, reducing heart rate, myocardial contractility, cardiac output, and renin release. Indicated for hypertension, stable angina pectoris, heart failure, cardiac arrhythmias, and post-myocardial infarction secondary prevention.

Telmisartan is a potent, non-peptide, long-acting angiotensin II type 1 (AT1) receptor antagonist on the WHO Model List of Essential Medicines. It exhibits an exceptionally long elimination half-life (around 24 hours) providing sustained 24-hour blood pressure control with high trough-to-peak ratio, and uniquely functions as a partial agonist at peroxisome proliferator-activated receptor-gamma (PPAR-gamma), improving glucose handling and lipid metabolism. Indicated for essential hypertension and cardiovascular risk reduction in patients with coronary artery disease, stroke, or diabetes with end-organ damage.