ESH-ESC guidelines for the management of hypertension.

Détails

ID Serval
serval:BIB_ED50208EE073
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
ESH-ESC guidelines for the management of hypertension.
Périodique
Herz
Auteur⸱e⸱s
Erdine S., Ari O., Zanchetti A., Cifkova R., Fagard R., Kjeldsen S., Mancia G., Poulter N., Rahn K.H., Rodicio J.L., Ruilope L.M., Staessen J., van Zwieten P., Waeber B., Williams B.
ISSN
0340-9937
Statut éditorial
Publié
Date de publication
2006
Peer-reviewed
Oui
Volume
31
Numéro
4
Pages
331-338
Langue
anglais
Résumé
The following is a brief statement of the 2003 European Society of Hypertension (ESH)-European Society of Cardiology (ESC) guidelines for the management of arterial hypertension.The continuous relationship between the level of blood pressure and cardiovascular risk makes the definition of hypertension arbitrary. Since risk factors cluster in hypertensive individuals, risk stratification should be made and decision about the management should not be based on blood pressure alone, but also according to the presence or absence of other risk factors, target organ damage, diabetes, and cardiovascular or renal damage, as well as on other aspects of the patient's personal, medical and social situation. Blood pressure values measured in the doctor's office or the clinic should commonly be used as reference. Ambulatory blood pressure monitoring may have clinical value, when considerable variability of office blood pressure is found over the same or different visits, high office blood pressure is measured in subjects otherwise at low global cardiovascular risk, there is marked discrepancy between blood pressure values measured in the office and at home, resistance to drug treatment is suspected, or research is involved. Secondary hypertension should always be investigated.The primary goal of treatment of patient with high blood pressure is to achieve the maximum reduction in long-term total risk of cardiovascular morbidity and mortality. This requires treatment of all the reversible factors identified, including smoking, dislipidemia, or diabetes, and the appropriate management of associated clinical conditions, as well as treatment of the raised blood pressure per se. On the basis of current evidence from trials, it can be recommended that blood pressure, both systolic and diastolic, be intensively lowered at least below 140/90 mmHg and to definitely lower values, if tolerated, in all hypertensive patients, and below 130/80 mmHg in diabetics.Lifestyle measures should be instituted whenever appropriate in all patients, including subjects with high normal blood pressure and patients who require drug treatment. The purpose is to lower blood pressure and to control other risk factors and clinical conditions present.In most, if not all, hypertensive patients, therapy should be started gradually, and target blood pressure achieved progressively through several weeks. To reach target blood pressure, it is likely that a large proportion of patients will require combination therapy with more than one agent. The main benefits of antihypertensive therapy are due to lowering of blood pressure per se. There is also evidence that specific drug classes may differ in some effect or in special groups of patients. The choice of drugs will be influenced by many factors, including previous experience of the patient with antihypertensive agents, cost of drugs, risk profile, presence or absence of target organ damage, clinical cardiovascular or renal disease or diabetes, patient's preference.
Mots-clé
Age Factors, Aged, Aged, 80 and over, Antihypertensive Agents, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Cardiology, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Diastole, Diet, Drug Therapy, Combination, Dyslipidemias, Europe, Exercise, Female, Humans, Hypertension, Kidney Diseases, Life Style, Male, Middle Aged, Prognosis, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Sex Factors, Societies, Medical, Systole
Pubmed
Web of science
Création de la notice
06/03/2009 12:00
Dernière modification de la notice
20/08/2019 16:15
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