Leontsinis Ioannis, Mantzouranis Manos, Tsioufis Panagiotis, Andrikou Ioannis, Tsioufis Costas
First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 108 Vas. Sofias Ave, 11527, Athens, Greece.
Fac Rev. 2020 Nov 4;9:4. doi: 10.12703/b/9-4. eCollection 2020.
Hypertension remains a leading risk factor for cardiovascular mortality and morbidity globally despite the availability of effective and well-tolerated antihypertensive medications. Accumulating evidence suggests a more aggressive blood pressure regulation aimed at lower targets, particularly for selected patient groups. Our concepts of the optimal method for blood pressure measurement have radically changed, maintaining appropriate standard office measurements for initial assessment but relying on out-of-office measurement to better guide our decisions. Thorough risk stratification provides guidance in decision making; however, an individualized approach is highly recommended to prevent overtreatment. Undertreatment, on the other hand, remains a major concern and is mainly attributed to poor adherence and resistant or difficult-to-control forms of the disease. This review aims to present modern perspectives, novel treatment options, including innovative technological applications and developing interventional and pharmaceutical therapies, and the major concerns emerging from several years of research and epidemiological observations related to hypertension management.
尽管有有效且耐受性良好的抗高血压药物,但高血压仍是全球心血管疾病死亡率和发病率的主要危险因素。越来越多的证据表明,应针对更低目标进行更积极的血压调节,特别是对于特定患者群体。我们对血压测量最佳方法的概念已发生了根本性变化,在初始评估时保持适当的标准诊室测量,但依靠诊室外测量来更好地指导我们的决策。全面的风险分层为决策提供指导;然而,强烈建议采用个体化方法以防止过度治疗。另一方面,治疗不足仍然是一个主要问题,主要归因于依从性差以及疾病的难治或难以控制的形式。本综述旨在介绍现代观点、新的治疗选择,包括创新技术应用以及正在发展的介入和药物治疗,以及与高血压管理相关的数年研究和流行病学观察中出现的主要问题。