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Management of hypertension in 2017: targets and therapies

Monica Ahluwalia1, Sripal Bangalore

  • 1New York University Langone Medical Center, New York, New York, USA.

Current Opinion in Cardiology
|March 28, 2017
PubMed

Insights

Managing hypertension is crucial for reducing cardiovascular risks. Current strategies involve individualized blood pressure targets and combination drug therapies, balancing benefits against potential side effects and costs.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Hypertension affects approximately 25% of adults, significantly increasing cardiovascular morbidity and mortality.
  • Early detection and treatment of hypertension are vital for reducing adverse cardiovascular events.
  • Cardiovascular risks associated with hypertension include heart attack, stroke, heart failure, and cardiovascular death.

Purpose of the Study:

  • To review current management and treatment strategies for hypertension.
  • To discuss blood pressure targets based on recent literature and guidelines.
  • To consider varying clinical characteristics, comorbidities, and patient-risk profiles in hypertension management.

Main Methods:

  • Review of recent literature and current clinical guidelines on hypertension management.
  • Analysis of studies investigating blood pressure targets, including the SPRINT trial.
  • Evaluation of first-line antihypertensive medications and combination therapy approaches.

Main Results:

  • Controversy exists regarding optimal blood pressure targets in coronary artery disease patients, with some evidence suggesting a J-curve effect.
  • Lower blood pressure targets may necessitate increased medication, impacting cost, compliance, and adverse effects.
  • Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium antagonists, and thiazide diuretics are recognized first-line therapies.
  • Combination drug therapy demonstrates synergistic effects for blood pressure reduction, side effect management, and improved adherence compared to monotherapy.

Conclusions:

  • Current hypertension management requires personalized blood pressure targets and therapeutic strategies.
  • Combination therapy is often preferred for enhanced efficacy and tolerability.
  • Balancing treatment benefits with medication-related costs and adverse effects is essential.
Abstract

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