Adjusting the hypertension regimen. Simple method based on circulatory assessment

Simple clinical observations allow the physician to obtain clues as to whether hypertension is volume-mediated, due to cardiodynamic factors (increased heart rate and contractility), or due to increased peripheral vascular resistance. When drugs are chosen to correct defined circulatory abnormalities, the effectiveness of antihypertensive therapy is maximized, circulatory balance is maintained, and side effects are minimized. In the five cases presented here, drug therapy was adjusted after clinical assessment showed a circulatory imbalance.