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[Treatment of hypertension and cardiovascular complications]
1Katedra kardiologie, Institutu pro dalsí vzdĕlávání lékarů a farmaceutů, Praha.
Insights
Effective hypertension management requires addressing multiple risk factors like high cholesterol and smoking. Individualized treatment plans are crucial for preventing cardiovascular events and improving patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Hypertension management is critical for preventing ischemic heart disease (IHD).
- Other risk factors like hyperlipoproteinaemia and smoking significantly influence treatment outcomes.
- Individualized treatment strategies are essential, considering patient age, hypertension severity, complications, and comorbidities such as diabetes mellitus.
Purpose:
- To outline the comprehensive approach to hypertension treatment.
- To highlight the importance of managing co-existing risk factors.
- To discuss specific pharmacological agents for hypertension and hyperlipoproteinaemia.
Summary:
- Normalization of blood pressure is the primary goal in hypertension treatment.
- Calcium antagonists, prazosin, ACE inhibitors, and beta-blockers with ISA are recommended for hyperlipoproteinaemia.
- Calcium antagonists and beta-blockers may inhibit atherosclerosis progression, while AGE inhibitors prevent hypertrophy.
Impact:
- Effective hypertension control can significantly reduce cerebrovascular attack mortality.
- Poor hypertension control in some populations, like Czechoslovakia historically, indicates a need for improved public health strategies.
- Aggressive management of hypertension and associated risk factors is vital for cardiovascular health.
Abstract:
The aim in treatment of hypertension is normalization of blood pressure. The impact of treatment of hypertension on the development of IHD depends not only on the treatment of hypertension but also on influencing other basic risk factors, i.e. hyperlipoproteinaemia and smoking. Treatment of hypertension can be and should be individual and depends on a) age, b) the level of hypertension, c) complications of hypertension and d) the presence of other diseases, in particular hyperlipoproteinaemia and diabetes mellitus. The treatment of choice in hyperlipoproteinaemia are calcium antagonists, prazosin, ACE inhibitors and beta-blockers with ISA. There is experimental evidence suggesting that calcium antagonists (in particular isradipine) but also beta-blockers suppress the progression of atherosclerosis and AGE inhibitors prevent the development of cardiac and vascular hypertrophy. Effective treatment leads to a decline in the mortality from cerebrovascular attacks--in the USA in the course of 20 years a decline by 60%--in Czechoslovakia so far the mortality from cerebrovascular disease did not change which indicates unfortunately a very poor control of hypertension in the population.