title: [Present-day treatment of arterial hypertension].
abstract: The treatment goal of patients with arterial hypertension is to reduce the blood pressure below 140/90 mmHg with the aim to lower the risk of subsequent cardiovascular diseases and to prolong patient's longevity. There are five main classes for blood pressure treatment: ACE-inhibitors, angiotensin II receptor blockers, beta-receptor blockers, calcium channel blockers, and thiazide diuretics. All these antihypertensive drugs have in common that they are able to lower the arterial blood pressure in a similar range. If drugs have similar effects, those with additional beneficial effects on patient's comorbidity should be preferred. Some antihypertensive drugs such as inhibitors of the renin-angiotensin-aldosteron system (RAAS) additionally have organ protective properties. ACE-inhibitors and angiotensin receptor blockers should be preferred in patients with a high cardiovascular risk such as coronary heart disease, heart failure, diabetes, and chronic kidney disease. A preferred approach is the initial prescription of a low dose combination to bring more hypertensive patients to their target blood pressure. Most combination drugs contain a thiazide diuretic. A better combination especially for diabetics seems to be a calcium channel blocker together with a RAAS inhibitor. A possible combination for patients with coronary heart disease or heart failure is a RAAS inhibitor combined with a beta-receptor blocker.
authors.affiliation: Medizinische Klinik, Friedrich-Ebert-Krankenhaus, Friesenstrasse 11, 24531 Neumünster. andreas.schuchert@fek.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuchert
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004359:Drug Therapy, Combination; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications
chemical_list: D000959:Antihypertensive Agents