[Management of arterial hypertension]

Herz. 2017 Aug;42(5):515-526. doi: 10.1007/s00059-017-4574-1.
[Article in German]

Abstract

Arterial hypertension has a high prevalence and is a major risk factor for the development of cardiovascular diseases. It is a major contributor to worldwide morbidity and mortality and hence poses a huge socioeconomic burden. Despite great progress in perception, diagnosis and treatment of hypertension, blood pressure control is inadequate in less than half of the hypertensive patients (<140/90 mm Hg). The diagnosis of arterial hypertension starts in most patients with the conventional office blood pressure measurement. Out-of-office blood pressure measurement is an important adjunct, especially to unmask white-coat hypertension. To reach the right target blood pressure many effective antihypertensive drugs are available. By how much the blood pressure should be lowered is currently a matter of controversy. The 2013 European and the identical German national guidelines recommend a target blood pressure of <140/90 mm Hg for most patients. The recent SPRINT study revealed that some patients may benefit from an even lower blood pressure. This CME-article summarizes recent developments in the management of arterial hypertension and provides tips for daily practice based on these aims.

Keywords: Antihypertensive agents; Arterial hypertension; Diagnosis; Non-pharmacological treatment; Target blood pressure.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Blood Pressure Monitoring, Ambulatory
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Germany
  • Guideline Adherence
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Male
  • Middle Aged
  • Reference Values
  • Risk Factors
  • White Coat Hypertension / diagnosis
  • White Coat Hypertension / drug therapy
  • White Coat Hypertension / epidemiology
  • White Coat Hypertension / etiology

Substances

  • Antihypertensive Agents