Interní Med. 2011; 13(3): 106-108

Arterial hypertension and chronic heart failure

MUDr.Markéta Hegarová

Klinika kardiologie IKEM, Praha

Pharmacotherapy of the essential hypertension is the effective prevention of the development of chronic heart failure (CHF). If blood

pressure is not even in the complete heart failure pharmacotherapy well controlled, it is the indication for further therapeutic influence.

A combination of treatment is available – with inhibitors of RAAS system, ACE-I and ARB under strict control of potassium levels and

renal functions. This approach will benefit in particular patients with hope to myocardial reverse remodeling and in patiens in advanced

stages of a disease, receiving ACE-I in the long term with assumptive escape phenomenon. New option is to add a renin-direct inhibitor

aliskiren, whose effect on the mortality must still be confirmed. If we cannot achieve normalisation of blood presure despite combined

block of RAAS or is this treatment intolerable, addition of amlodipine is possible. Central sympathetic inhibitors are not advisable. It is

essential to exclude a secondary hypertension.

Keywords: chronic heart failure, reverse myocardial remodelling, escape phenomenon, aliskiren

Published: March 16, 2011  Show citation