Interní Med. 2017; 19(1): 10-15 | DOI: 10.36290/int.2017.045

Current trends in drug treatment of hypertension

prof. MUDr. Renata Cífková, CSc.

Centrum kardiovaskulární prevence 1. LF UK a Thomayerovy nemocnice, Praha, II. interní klinika – klinika kardiologie a angiologie, 1. LF UK a VFN, Praha, Mezinárodní centrum klinického výzkumu, Brno

New knowledge in the field of hypertension is summarized in the 2016 European Guidelines on cardiovascular disease prevention

in clinical practice. A piece of novelty is automated repeated office BP measurement performed in a separate room (without presence

of other persons), which may improve reproducibility and has a better correlation with daytime BP values during 24-hour

ABPM or with home BP measurement. The decision to initiate antihypertensive treatment depends on BP level and total CV risk.

Antihypertensive medication is initiated sooner or later in most hypertensive patients. Lifestyle changes only with close BP monitoring

should be the recommendation in young individuals with isolated moderate elevation of brachial SBP and in those with

high normal BP at low or moderate risk. The main benefit of BP-lowering treatment is due to BP lowering per se. As thiazides and

thiazide-like diuretics, beta-blockers, calcium-channel blockers, ACEIs and ARBs adequately lower BP and reduce CV morbidity

and mortality, they are recommended for initiation and maintenance of BP control, either as monotherapy or in combination.

A BP level < 140/90 mmHg continues to be the goal for the majority of hypertensive patients.

Keywords: blood pressure, blood pressure measurement, office blood pressure measurement, automatic office blood pressure measurement, goal blood pressure, antihypertensive medication

Accepted: January 19, 2018; Published: February 1, 2017  Show citation