title: Pathophysiologic therapeutic targets in hypertension: a cardiological point of view.
abstract: BACKGROUND
  Treatment of arterial hypertension can be a difficult exercise. Anti-hypertensive treatments need to be administered, keeping in mind the pathophysiological mechanisms and correlates at the base of arterial hypertension in the specific patient.
  
  
  METHODS
  The common pathophysiological mechanisms at the base of hypertension and their undisputed mechanistic relationship with clinical events. Additionally, the mounting evidence showing that, from their changes, it may be possible to predict the clinical outcome of patients. Data was sourced from Medline and the Cochrane library. Which were searched from January 1986 to May 2011 to find relevant papers outlining the relation between hypertension, pathophysiology, medical treatment and side/adverse effects of anti-hypertensive drugs.
  
  
  CONCLUSIONS
  It appears that the hypertensive patient in the cardiological context is often a subject with a 'complex' health status (e.g., glucose intolerant/diabetic carrier of serum lipids disorder) and as such, he/she should be treated in a 'holistic' pharmacological way. All the ancillary positive and negative effects of the administered drugs should not be dismissed. From a pathophysiological point of view, inhibitors of the renin-angiotensin-aldosterone system could be considered as the most appropriate drugs for the treatment of arterial hypertension and its correlates, especially in the high-risk patient.
authors.affiliation: Heart Failure Clinic, Istituto Scientifico San Raffaele, via Olgettina 60, 20132 Milano, Italy. gabriele.fragasso@hsr.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fragasso
authors.forename: Francesco
authors.initials: F
authors.lastname: Maranta
authors.forename: Claudia
authors.initials: C
authors.lastname: Montanaro
authors.forename: Anna
authors.initials: A
authors.lastname: Salerno
authors.forename: Camilla
authors.initials: C
authors.lastname: Torlasco
authors.forename: Alberto
authors.initials: A
authors.lastname: Margonato
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000318:Adrenergic beta-Agonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics