Arterial Hypertension (Management of)

Topics: Hypertension

Authors

Table of contents: Full Text (ESC Clinical Practice Guidelines)

Definition and classification of hypertension

• Systolic versus diastolic and pulse pressure, Classification of hypertension, Total cardiovascular risk, Concept, Assessment, Limitations

Diagnostic evaluation

• Blood pressure measurement, Office or clinic blood pressure, Ambulatory blood pressure, Home blood pressure, Isolated office or white coat hypertension, Isolated ambulatory or masked hypertension, Blood pressure during exercise and laboratory stress, Central blood pressure, Family and clinical history, Physical examination, Laboratory investigations, Genetic analysis, Searching for subclinical organ damage, Heart, Blood vessels, Kidney, Fundoscopy, Brain

Evidence for therapeutic management of hypertension

• Introduction, Event based trials comparing active treatment to placebo, Event based trials comparing more and less intense blood pressure lowering, Event based trials comparing different active treatments, Calcium antagonists versus thiazide diuretics and b-blockers, ACE inhibitors versus thiazide diuretics and b-blockers, ACE inhibitors versus calcium antagonists, Angiotensin receptor antagonists versus other drugs, Trials with b-blockers, Conclusions, Randomized trials based on intermediate endpoints, Heart, Arterial wall and therosclerosis, Brain and cognitive function, Renal function and disease, New onset diabetes

Therapeutic approach

• When to initiate antihypertensive treatment, Goals of treatment, Blood pressure target in the general hypertensive population, Blood pressure targets in diabetic and very high or high risk patients, Home and ambulatory blood pressure targets, Conclusions, Cost-effectiveness of antihypertensive treatment

Treatment strategies

• Lifestyle changes, Smoking cessation, Moderation of alcohol consumption, Sodium restriction, Other dietary changes, Weight reduction, Physical exercise, Pharmacological therapy, Choice of antihypertensive drugs, Monotherapy, Combination treatment

Therapeutic approach in special conditions

• Elderly, Diabetes mellitus, Cerebrovascular disease, Stroke and transient ischaemic attacks, Cognitive dysfunction and dementia, Coronary heart disease and heart failure, Atrial fibrillation, Non-diabetic renal disease, Hypertension in women, Oral contraceptives, Hormone replacement therapy, Hypertension in pregnancy, Metabolic syndrome, Resistant hypertension, Hypertensive emergencies, Malignant hypertension

Treatment of associated risk factors

• Lipid lowering agents, Antiplatelet therapy, Glycaemic control

Screening and treatment of secondary forms of hypertension

• Renal parenchymal disease, Renovascular hypertension, Phaeochromocytoma, Primary aldosteronism, Cushing’s syndrome, Obstructive sleep apnoea, Coarctation of the aorta, Drug-induced hypertension