Via practica 6/2023

Drug treatment strategy for arterial hypertension depending on the target group of patients (diabetes mellitus, obesity, metabolic syndrome)

The goal of effective management of arterial hypertension is to maintain optimal blood pressure values in the long term, thus preventing and/or reducing the cardiovascular risk of organ complications. As the situation in morbidity and mortality from cardiovascular diseases is unfavorable in Slovakia, this task is all the more urgent. The renin-angiotensin-aldosterone system (RAAS) plays a fundamental role in the physiology of blood pressure control and the pathophysiology of hypertension with effects on vascular tone, sodium retention, oxidative stress, fibrosis, sympathetic tone, and inflammation. In the strategy for the treatment of hypertension in patients with diabetes mellitus, obesity or metabolic syndrome, it is recommended to start medical treatment with a combination of a RAAS inhibitor with a CCB or with a thiazide/thiazide-like diuretic. Fixed combinations of antihypertensive drugs contribute to improved adherence and persistence to treatment, with a reduction in cardiovascular events and overall mortality.

Keywords: arterial hypertension, treatment, comorbidities, cardiovascular diseases