[Recent intervention studies with antihypertensive drugs and their influence on guidelines].
Antihypertensive therapy improves the prognosis of essential hypertension. Therapy reduces mortality and decreases the incidence of myocardial infarction, sudden cardiac death and stroke. Target blood pressure in patients with essential hypertension are levels < or = 140/90 mmHg. In patients with essential hypertension and concomitant diabetes mellitus type 2, blood pressure should be lowered to < or = 130/80 mmHg. Diuretics, beta-blockers, calcium antagonists, angiotensin-converting enyzme (ACE) inhibitors, and angiotensin I (AT(1)) antagonists may nowadays be regarded as drugs of first choice in the treatment of essential hypertension. The Joint National Committee in the USA recommends to start treatment with a thiazide diuretic. A Guidelines Committee of European Society of Hypertension-European Society of Cardiology considers the Endgroups of drugs mentioned above to be equally suitable for the initiation and maintenance of antihypertensive therapy. Both groups of experts agree that in the majority of patients with essential hypertension, a combination of two or more drugs is required to reach target blood pressure. Both groups of experts emphasize that the main benefits of antihypertensive therapy are due to decreasing blood pressure per se.
Rahn
Karl-Heinz
KH
Medizinische Klinik und Poliklinik D, Universitätsklinikum, Muenster. karl-heinz.rahn@ukmuenster.de
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001581:Benzothiadiazines; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D002752:Chlorthalidone / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D017706:Lisinopril / Q000008:administration & dosage / Q000627:therapeutic use; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D020521:Stroke / Q000517:prevention & control; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001581:Benzothiadiazines; D002121:Calcium Channel Blockers; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D017311:Amlodipine; D017706:Lisinopril; D002752:Chlorthalidone