[New goals in hypertension management: target-organ protection beyond blood pressure lowering].
Recent data from experimental studies and clinical trials of antihypertensive therapies serve to underline the need to achieve the following three objectives during hypertension management in order to minimise the risks of morbidity and mortality from cardiovascular disease:good blood pressure control, especially control of systolic blood pressure (SBP) and pulse pressure;optimal prevention of target-organ damage, particularly in the heart, brain and kidneys;action against underlying vascular disease, including reducing large artery stiffness and improving the structural and functional status of the microcirculation (resistance arteries, arterioles, capillaries and venules), which improves myocardial perfusion and reduces the risk of coronary insufficiency. It is therefore now important to assess the efficacy of any new antihypertensive strategy with regard to not only its ability to reduce blood pressure, but also its impact on structural and functional alterations to large and small blood vessels, and its ability to preserve cardiac and renal function in the hypertensive patient.
Safar
Michel E
ME
Service de Médecine Interne, Hôpital Broussais, Paris, France. michel.safar@brs.ap-hop-paris.fr
Struijker-Boudier
Harry A J
HA
D000959:Antihypertensive Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D008833:Microcirculation / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D014655:Vascular Resistance
D000959:Antihypertensive Agents
Nouveaux objectifs dans la prise en charge de l'hypertension: au-delà de l'abaissement de la pression artérielle, la protection des organes-cibles