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Published on: May 26, 2022
Hypertension - state of the art 2015
1St Bartholomew's Hospital, Barts Health NHS Trust, London, UK cnfloyd@doctors.org.uk.
Insights
Effective hypertension management remains a challenge, with many patients not reaching blood pressure targets. Novel therapies like LCZ696 and patient-centered approaches are crucial for improving outcomes in cardiovascular disease.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension is a major reversible risk factor for global morbidity and mortality.
- Current therapeutic strategies achieve blood pressure control in less than half of treated patients.
- Uncertainty in optimal treatment strategies contributes to suboptimal hypertension management.
Purpose of the Study:
- To review recent advances in hypertension understanding and management.
- To discuss novel therapeutic strategies and patient-centered care in hypertension.
- To highlight the role of upcoming PATHWAY studies in guiding treatment.
Main Methods:
- Expert panel discussion at a conference.
- Review of current therapeutic approaches and emerging treatments.
- Consideration of patient involvement in treatment adherence and lifestyle modification.
Main Results:
- Less than 50% of hypertensive patients achieve guideline-recommended blood pressure control.
- LCZ696 shows potential as a novel therapeutic option with benefits beyond blood pressure lowering.
- Patient-centered care is vital for medication adherence and lifestyle changes.
Conclusions:
- Optimizing hypertension management requires addressing treatment strategy uncertainties.
- Novel drug targets, such as natriuretic peptide degradation, offer new therapeutic avenues.
- Integrating patient involvement is essential for successful, long-term hypertension control and improved cardiovascular health.
Abstract:
A conference organised in conjunction with the British Hypertension Society at the Royal College of Physicians (London) assembled an expert panel to present recent advances in the understanding and management of hypertension - the leading reversible risk factor for global morbidity and mortality. Despite recognised therapeutic approaches, less than half of patients on treatment for hypertension achieve blood pressure control to international guideline-based targets. This failure may, in part, be due to uncertainty into optimum treatment strategies, and the PATHWAY studies reporting later this year will hopefully address some outstanding questions relating to the standardised ABCD approach to drug selection. Targeting degradation of natriuretic peptides by LCZ696 (a combination of valsartan and a neutral endopeptidase inhibitor) has demonstrated potential as a novel therapeutic option, with mortality benefits in heart failure beyond that solely attributable to its blood pressure lowering ability. However, critical to any therapeutic strategy is patient involvement, and it is clear that the delivery of patient-centric treatment options is vital to ensure adherence with medication and to facilitate healthier lifestyle decisions.
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