[Antihypertensive drug therapy : Where do we stand?]

Antihypertensive drug therapy is one of the most successful medical measures ever, at all levels. The treatment situation in Germany has clearly improved in recent years. Nowadays, a wide range of very effective and well-tolerated hypertensive substances is available. Combination therapy has a long and successful tradition in hypertensive treatment, especially with suitable fixed combinations. Furthermore, the administration of fixed combinations is very beneficial to therapy adherence because it is essentially dependent on the number of drugs to be taken. The value of beta blockers and the double blockade of the renin-angiotensin-aldosterone system are under discussion and the interpretation of corresponding studies must be conducted very carefully. The hypertensive effect of a substance cannot be comprehensively assessed without taking the time of day, the time point of measurement and the time point of intake into consideration. This is particularly important with respect to the effect over 24 h. Optimal antihypertensive therapy must also take into consideration the individual blood pressure rhythm with respect to the dose and dosing intervals. The importance of the central (aortic) blood pressure as target blood pressure will increase.