New aspects in management of arterial hypertension – 2007 ESH/ESC guidelines

Abstract:

In this review were emphasized some new aspects in management of arterial hypertension according to 2007 ESH/ESC guidelines. More precise assessment of total cardiovascular risk is required to diagnose high blood pressure and guide treatment. Routine assessment of organ damage now includes microalbuminuria, estimated glomerular filtration rate or estimated creatinine clearance, among others. Metabolic syndrome is new category in stratification of cardiovascular risk. Goals of treatment are prevention of worsening of organ damage and appearance of high-risk conditions besides reduction of cardiovascular events. In that view lifestyle changes are recommended for everyone. All 5 drug classes can be used to initiate and maintain antihypertensive treatment but should be kept in mind diabetogenic effect of b-blockers and diuretics. Majority of hypertensives required combination treatment, so selection the drug of first choice become irrelevant accepting the fact that evidence supports the use of some drugs versus others in various conditions. Guidelines kept their educational and advisably character with individual approach to single patient trying to improve implementation in everyday practice. 

Key words:
hypertension, guidelines, target organ damage, antihypertensive treatment