Hypertension management in patients with cardiovascular comorbidities.
Lucas LauderFelix MahfoudMichel AziziDeepak L BhattSebastian EwenKazuomi KarioGianfranco ParatiPatrick RossignolMarkus P SchlaichKoon K TeoRaymond R TownsendCostas TsioufisMichael A WeberThomas WeberMichael BöhmPublished in: European heart journal (2022)
Arterial hypertension is a leading cause of death globally. Due to ageing, the rising incidence of obesity, and socioeconomic and environmental changes, its incidence increases worldwide. Hypertension commonly coexists with Type 2 diabetes, obesity, dyslipidaemia, sedentary lifestyle, and smoking leading to risk amplification. Blood pressure lowering by lifestyle modifications and antihypertensive drugs reduce cardiovascular (CV) morbidity and mortality. Guidelines recommend dual- and triple-combination therapies using renin-angiotensin system blockers, calcium channel blockers, and/or a diuretic. Comorbidities often complicate management. New drugs such as angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists improve CV and renal outcomes. Catheter-based renal denervation could offer an alternative treatment option in comorbid hypertension associated with increased sympathetic nerve activity. This review summarises the latest clinical evidence for managing hypertension with CV comorbidities.
Keyphrases
- blood pressure
- arterial hypertension
- metabolic syndrome
- weight loss
- hypertensive patients
- physical activity
- heart rate
- insulin resistance
- angiotensin converting enzyme
- type diabetes
- cardiovascular disease
- risk factors
- weight gain
- blood glucose
- high fat diet induced
- body mass index
- skeletal muscle
- smoking cessation
- heart failure
- clinical practice
- anti inflammatory drugs
- glycemic control
- acute heart failure