Thursday, February 17, 2011
Abstract (Optimale dosering geneesmiddelen hoge bloeddruk)
Control of cardiovascular (CV) risk factors, particularly hypertension, is still unsatisfactory, resulting in excess CV morbidity and mortality worldwide. CV risk is linearly associated with an increase in blood pressure (BP) values, and clinical studies have clearly demonstrated that BP lowering represents the most effective means of preventing CV events. However, while BP reduction is a fairly easy target, BP normalization is much more difficult to achieve, and adequate BP control (<140/90>
1. Introduction
Despite the great value that we attribute to scientific literature and guidelines, very often the clinical reality is far from what would be expected on the basis of shared knowledge. Atypical example is the effectiveness of hypertension treatment in the general population. It is well established that cardiovascular (CV) diseases represent the leading causes of morbidity and mortality worldwide, and that this is related to the high prevalence of CV risk factors and the failure to control them adequately.[1,2] Essential hypertension is considered the most important CV risk factor on the basis of its very high incidence (around 50% in the adult population) and its direct, linear relationship with CV events.[3,4]
Treatment of hypertensive patients is based on blood pressure (BP) normalization, which represents the main mechanism by which antihypertensive treatment reduces morbidity and mortality.[5] In line with this, the 2007 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines on the management of hypertension recommend a target BP within the range of 130–139/80–89mmHg in all hypertensive patients.[6,7]
In this review, we discuss how clinical pharmacology can be used to achieve BP goals in patients with hypertension.
PubMed searches were performed for English-language articles on the treatment of hypertension, antihypertensive therapy, combination therapy in hypertension, and clinical pharmacology of antihypertensive drugs, published from 2000 to the present. In particular, reviews, consensus statements/guidelines, and meta-analyses relevant to the above-mentioned issues were included. Earlier works, particularly those concerning the clinical pharmacology of antihypertensive drugs, were also evaluated. As a limitation, it has to be noted that this is not a systematic and exhaustive review of the published literature. This was beyond the purpose of this review, which was to merge the evidence from clinical trials, pharmacology studies, and the recommendations of international guidelines, in order to implement them in daily practice.
|
| Section 1 of 6 |
|
