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A world with 1.56 billion hypertensives in 2025

Session presentations

  • Can early blood pressure lowering treatment prevent hypertension? Presented by S E Kjeldsen (Oslo, NO) congress 365 
  • Do non-pharmacological measures work? Presented by R Fagard (Leuven, BE) congress 365 
  • The different faces of the renin-angiotensin-aldosterone system blockade. Presented by M Burnier (Lausanne, CH) congress 365 
  • The future of antihypertensive treatment. Presented by G Mancia (Monza, IT)
Hypertension


Hypertension will continue to be a major risk factor for cardiovascular, renal and other complications and its prevalence will be of 1.56 billion in the next years. There are many reasons a) the targets of blood pressure are reached by only 20-30% of patients, b) the other coexisting risk factors that may increase the prevalence of hypertension are increasing rapidly.

Can intervention in early stages (ie prehypertension) prevent hypertension? It is difficult to answer this question, however there are some data showing that the use of some classes of antihypertensive drugs may delay the appearance of the disease in pre-hypertensive patients. However, in pre-hypertensive patients and mainly in those with multiple risk factors the most important preventive measure is life style modifications.

So, is non-pharmacological treatment effective?  Life style changes such as weight reduction, salt restriction, exercise etc. may decrease blood pressure by 2-10 mm Hg. The main problem is the compliance of the patients because their majority will stop the non-pharmacologic interventions in less than six months.
What is the future of antihypertensive treatment? For sure, the larger the number of therapeutic options, the better the blood pressure control. However, because there are only five drug classes for first line treatment, the previous, but also the upcoming ESH/ESC guidelines will help doctors to select the right drug class for the right patient, the right condition.

Finally, it is important to remember that most patients need combination treatment and our goal is to find the right combination in accordance with the presence of risk factors, subclinical and clinical organ damage. 

References


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A world with 1.56 billion hypertensives in 2025

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.