[Management of hypertensive patients in private practice].
In private practice mild or moderate arterial hypertension is controlled primarily to prevent the development of a severe, organ-damaging hypertensive disease. The general practitioner's approach to management proceeds in 3 steps. 1) He must decide to initiate a treatment after obtaining sufficient evidence that the hypertension is permanent and after starting to correct the associated risk factors. 2) He must select a single-drug initial treatment among the four families of antihypertensive medications, viz.: diuretics, beta-blockers, angiotensin-converting enzyme inhibitors and calcium antagonists. The selection is based on the information available concerning the benefit/risk ratio of the preferred drug, its interactions with the pathologies that are often associated with hypertension, and its acceptability. Finding for each patient the optimal dosage with maximum effectiveness and minimum undesirable side-effects is of prime importance. 3) If this initial treatment fails, the practitioner must first make sure that his prescription was optimal in dosage and compliance. If this was the case, he must make a choice between another single-drug therapy and a combination therapy, using by preference two synergistic drugs in low doses.
Imbs
J L
JL
Service d'hypertension et des maladies vasculaires, CHRU, Strasbourg.
Welsch
M
M
Stephan
D
D
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005194:Family Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D010347:Patient Care Planning; D010349:Patient Compliance
D000959:Antihypertensive Agents
La prise en charge des hypertendus en pratique de ville.