Arterial Hypertension.

Abstract

BACKGROUND:

Essential arterial hypertension is one of the main treatable cardiovascular risk factors. In Germany, approximately 13% of women and 18% of men have uncontrolled high blood pressure (≥ 140/90 mmHg).

METHODS:

This review is based on pertinent publications retrieved by a selective literature search in PubMed.

RESULTS:

Arterial hypertension is diagnosed when repeated measurements in a doctor's office yield values of 140/90 mmHg or higher. The diagnosis should be confirmed by 24-hour ambulatory blood pressure monitoring or by home measurement. Further risk factors and end-organ damage should be considered as well. According to the current European guidelines, the target blood pressure for all patients, including those with diabetes mellitus or renal failure, is <140/90 mmHg. If the treatment is well tolerated, further lowering of blood pressure, with a defined lower limit, is recommended for most patients. The main non-pharmacological measures against high blood pressure are reduction of salt in the diet, avoidance of excessive alcohol consumption, smoking cessation, a balanced diet, physical exercise, and weight loss. The first-line drugs for arterial hypertension include long-acting dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and thiazide-like diuretics. Mineralocorticoid-receptor blockers are effective in patients whose blood pressure cannot be brought into acceptable range with first-line drugs.

CONCLUSION:

In most patients with essential hypertension, the blood pressure can be well controlled and the cardiovascular risk reduced through a combination of lifestyle interventions and first-line antihypertensive drugs.

• Authors: Jens Jordan, Christine Kurschat, Hannes Reuter
• Journal: Deutsches Arzteblatt international (Dtsch Arztebl Int) Vol. 115 Issue 33-34 Pg. 557-568 (08 20 2018) ISSN: 1866-0452 [Electronic] Germany
• PMID: 30189978 (Publication Type: Journal Article)

Chemical References

• Antihypertensive Agents

Topics

• Adult
• Aged
• Antihypertensive Agents (therapeutic use)
• Female
• Germany (epidemiology)
• Humans
• Hypertension (diagnosis, epidemiology, physiopathology)
• Male
• Mass Screening (methods)
• Middle Aged
• Risk Reduction Behavior