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Antihypertensive strategy: a current and prospective review
1Department of Internal Medicine, Red Cross Hospital, Barcelona, Spain.
The American Journal of Cardiology
|May 2, 1990
Summary
Antihypertensive therapy effectively reduces cardiovascular and cerebrovascular complications. While the classic stepped-care approach is useful, newer agents and individualized treatment are recommended, especially for elderly patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Antihypertensive therapy significantly reduces cardiovascular and cerebrovascular complications.
- The 1978 World Health Organization (WHO) recommended a stepped-care (SC) approach using diuretics and beta-blockers.
- The SC regimen improved hypertension control but has limitations.
Purpose of the Study:
- To review the efficacy of antihypertensive therapy.
- To discuss modifications to the classic SC approach.
- To highlight challenges in managing elderly hypertensive patients.
Main Methods:
- Review of clinical trials and expert committee recommendations.
- Analysis of demographic trends and treatment challenges.
- Evaluation of drug profiles, including newer agents and diuretics.
Main Results:
- Antihypertensive therapy reduces cerebrovascular complications by approximately 60%.
- The SC approach provided a standardized treatment guideline.
- Elderly patients present unique management challenges due to comorbidities and adverse effects.
Conclusions:
- Modifications to the SC approach are warranted, avoiding high-dose prescriptions.
- Newer agents like calcium antagonists and ACE inhibitors are recommended.
- Diuretics, particularly newer ones like indapamide, remain valuable due to improved metabolic profiles.