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Beyond the usual strategies for blood pressure reduction: therapeutic considerations and combination therapies

T D Giles1, G E Sander

  • 1Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|November 28, 2001
PubMed

Insights

Lowering blood pressure is crucial for cardiovascular health, especially in diabetics. Achieving lower blood pressure targets requires complex antihypertensive regimens, particularly for drug-resistant hypertension.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Elevated blood pressure is a key factor in cardiovascular disease, particularly in patients with diabetes mellitus.
  • Aggressive blood pressure reduction is therapeutically necessary to decrease cardiovascular event rates.

Purpose of the Study:

  • To provide suggestions for constructing complex antihypertensive regimens for patients with difficult-to-control hypertension, especially those with diabetes and chronic kidney disease.
  • To discuss considerations for diuretic use and effective drug combinations in antihypertensive therapy.

Main Methods:

  • This review synthesizes current clinical data and guidelines regarding blood pressure management.
  • It examines factors contributing to drug-resistant hypertension and proposes strategies to overcome them.

Main Results:

  • Current guidelines recommend progressively lower blood pressure targets, e.g., <=130/80 mm Hg for diabetics and <125/75 mm Hg for hypertensive renal disease with proteinuria.
  • Achieving these targets is challenging, often requiring multidrug regimens.

Conclusions:

  • Effective management of hypertension, particularly drug-resistant cases in diabetic patients with chronic kidney disease, necessitates optimized multidrug regimens.
  • Addressing issues like maximal drug dosing, appropriate diuretic use, and patient compliance is vital for successful blood pressure control.

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