title: 2012 consensus document of the Italian Society of Hypertension (SIIA): strategies to improve blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy.
abstract: Observational clinical studies have demonstrated that only 30-40% of patients with arterial hypertension achieve the recommended blood pressure goals (below 140/90 mmHg). In contrast, interventional trials consistently showed that it is possible to achieve effective blood pressure targets in about 70% of treated hypertensive patients with different cardiovascular risk profiles, especially through the use of rational, effective and well tolerated combination therapies. In order to bridge the gap between current and desired blood pressure control and to achieve more effective prevention of cardiovascular diseases, the Italian Society of Hypertension (SIIA) has developed an interventional strategy aimed at reaching nearly 70% of treated controlled hypertensive patients by 2015. This ambitious goal can be realistically achieved by a more rational use of modern tools and supports, and also through the use of combination therapy in hypertension in daily clinical practice, especially if this approach can be simplified into a single pill (fixed combination therapy), which is a therapeutic option now also available in Italy. Since about 70-80% of treated hypertensive patients require a combination therapy based on at least two classes of drugs in order to achieve the recommended blood pressure goals, it is of key importance to implement this strategy in routine clinical practice. Amongst the various combination therapies currently available for hypertension treatment and control, the use of those strategies based on drugs that antagonize the renin-angiotensin system, such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) and ACE inhibitors, in combination with diuretics and/or calcium channel blockers, has been shown to significantly reduce the risk of major cardiovascular events and to improve patient compliance to treatment, resulting in a greater antihypertensive efficacy and better tolerability compared with monotherapy. The present document of the Italian Society of Arterial Hypertension (SIIA) aims to gather the main indications for the implementation of combination therapy in the treatment of hypertension, in order to improve blood pressure control in Italy.
authors.affiliation: Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035-39, 00189, Rome, Italy. massimo.volpe@uniroma1.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.forename: Enrico Agabiti
authors.initials: EA
authors.lastname: Rosei
authors.forename: Ettore
authors.initials: E
authors.lastname: Ambrosioni
authors.forename: Santina
authors.initials: S
authors.lastname: Cottone
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
authors.forename: Francesco
authors.initials: F
authors.lastname: Fallo
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferri
authors.forename: Alberto
authors.initials: A
authors.lastname: Morganti
authors.forename: Maria Lorenza
authors.initials: ML
authors.lastname: Muiesan
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sarzani
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sechi
authors.forename: Agostino
authors.initials: A
authors.lastname: Virdis
authors.forename: Giuliano
authors.initials: G
authors.lastname: Tocci
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filippi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D007558:Italy; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations
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