Universität zu Köln

Jordan, Jens, Kurschat, Christine and Reuter, Hannes (2018). Arterial Hypertension Diagnosis and Treatment. Dtsch. Arztebl. Int., 115 (33-34). S. 557 - 569. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Essential arterial hypertension is one of the main treatable cardiovascular risk factors. In Germany, approximately 13% of women and 18% of men have uncontrolled high blood pressure (>= 140/90 mmHg). Methods: This review is based on pertinent publications retrieved by a selective literature search in PubMed. Results: Arterial hypertension is diagnosed when repeated measurements in a doctor's office yield values of 140/90 mmHg or higher. The diagnosis should be confirmed by 24-hour ambulatory blood pressure monitoring or by home measurement. Further risk factors and end-organ damage should be considered as well. According to the current European guidelines, the target blood pressure for all patients, including those with diabetes mellitus or renal failure, is <140/90 mmHg. If the treatment is well tolerated, further lowering of blood pressure, with a defined lower limit, is recommended for most patients. The main non-pharmacological measures against high blood pressure are reduction of salt in the diet, avoidance of excessive alcohol consumption, smoking cessation, a balanced diet, physical exercise, and weight loss. The first-line drugs for arterial hypertension include long-acting dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and thiazide-like diuretics. Mineralocorticoid-receptor blockers are effective in patients whose blood pressure cannot be brought into acceptable range with first-line drugs. Conclusion: In most patients with essential hypertension, the blood pressure can be well controlled and the cardiovascular risk reduced through a combination of lifestyle interventions and first-line antihypertensive drugs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jordan, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurschat, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-176198
DOI:	10.3238/arztebl.2018.0557
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	115
Number:	33-34
Page Range:	S. 557 - 569
Date:	2018
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-PRESSURE CONTROL; RESISTANT HYPERTENSION; RECEPTOR BLOCKERS; UNITED-STATES; RISK-FACTORS; HYDROCHLOROTHIAZIDE; METAANALYSIS; PREVALENCE; PREVENTION; MANAGEMENT Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17619