We present the core information from the "Reappraisal of European Guidelines on Hypertension Management", an official document of the European Society of Hypertension updating the current guidelines of 2007 based on the new knowledge that became available over the last two years. The division of antihypertensive agents into 5 main groups remains unchanged. The key discussion is about whether the treatment of hypertension in high-risk patients should be initiated already at high normal blood pressure and whether the target value should be 130 mm Hg and less. Both objectives are just speculative at present as they have not been confirmed in a large clinical study. Thanks to the HWET study we have more evidence for the benefits of hypertension therapy in older patients. Substantial part of the document focuses on combination therapy; the most encouraged combination is an ACE inhibitor + Ca blocker, or, alternatively, an ACE inhibitor or AII antagonist + diuretic. The beta-blocker + diuretic and ACE inhibitor + AII antagonist combinations are not recommended. Statins should be included in the therapy of all patients with hypertension, antiaggregation as a secondary prevention.

Interní kardiologická klinika Lékarské fakulty MU a FN Brno

Benefits and pitfalls of cardiovascular medication in seniors