[Rational approach to administration of combination therapy in arterial hypertension: modern recommendations and...

Area of Science:

• Cardiology
• Pharmacology

Background:

• Arterial hypertension (AH) management focuses on reducing blood pressure (BP) to prevent cardiovascular (CV) diseases and mortality.
• Target BP levels are <140/90 mm Hg for the general population and <140/80-85 mm Hg for diabetic patients.

Purpose of the Study:

• To outline rational pharmacotherapy for arterial hypertension.
• To emphasize initial combination therapy for high-risk patients.
• To highlight the importance of considering BP severity and risk factors in treatment.

Main Methods:

• Initial combination therapy is recommended for most patients, particularly those in high and very high-risk groups.
• Treatment decisions should consider both cardiovascular disease (CVD) risk category and the degree of AH.
• Starting with low doses of combination therapy may not be optimal for moderate to severe AH.

Main Results:

• For patients with moderate to severe AH (2-3 degree), initiating combination therapy with standard or higher doses can accelerate target BP achievement.
• Achieving target BP may be possible by increasing the dose of the initial combination therapy without adding a third drug.
• Comprehensive assessment of CV risk factors and subclinical target organ damage is essential.

Conclusions:

• Rational AH pharmacotherapy necessitates a focus on BP control, risk factor management, and early detection of target organ damage.
• Optimizing combination therapy, including dose adjustments, is key to effective BP management and CV risk reduction.
• Considering the prognostic significance of asymptomatic target organ damage is vital for comprehensive patient care.