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RESUMEN GENERAL
Journal of Hypertension 2013 European Heart Journal 2013 Blood Pressure 2013
Factors - other than office BP - influencing prognosis; used for stratification of total CV risk
Stratification of total CV risk in categories of low, moderate, high and very high risk
Predictive value, availability, reproducibility and costeffectiveness of some markers of organ damage
Recommended if SBP 160 mmHg IA (also > 80 80 ys of age) May be considered if SBP 140-159 mmHg IIbC IIIA
High normal BP
Choose between
(IIbC)
Single agent
Two-drug combination
Moving from a less intensive to a more intensive therapeutic strategy should be done whenever BP target is not achieved.
Fixed-dose combinations
Reducing the number of pills improves adherence (which is low in hypertension) and increases rate of BP control Approach facilitated by availability of different fixeddose combinations of the same two drugs (titration inconvenience minimized) This holds also for fixed-dose combinations of three drugs (usually RAS blocker / CA / D)
Only dihydropyridines to be combined with -blockers (except for verapamil or diltiazem for rate control in AF) Thiazides + -blockers increase risk of new onset DM ACEI + ARB combination discouraged (IIIA)
Major drug combinations used in trials of antihypertensive treatment in a step-up approach or as a randomized combination - 1
Major drug combinations used in trials of antihypertensive treatment in a step-up approach or as a randomized combination - 2