Afterload reduction may decrease the work of the heart and actually increase cardiac output. However, it will also cause a reduction in blood pressure, and many organs rely on pressure as well as flow for their function and performance. Thus the effects of afterload reduction vary depending on individual circumstances. There is no consensus as to how low blood pressure can be allowed to fall before medical intervention should be initiated, or which drugs should be used to reduce afterload (Table.. ..2). However, as a general guide the patient should not be allowed to have a prolonged episode where the systolic blood pressure is lower than the normal diastolic pressure.
Table 2 Choice of drugs for afterload reduction
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