Vnitr Lek 2021, 67(Suppl.C):24-27 | DOI: 10.36290/vnl.2021.103

Sedm otazníků v léčbě hypertenze

MUDr. Zuzana Zafarová

Sympozium hlavního sponzora výročního XXIX. kongresu České kardiologické společnosti bylo zaměřeno na léčbu hypertenze. Prof. MUDr. Aleš Linhart, DrSc., a prof. MUDr. Michal Vrablík, Ph.D., se podrobně zabývali cílovými hodnotami krevního tlaku pohybujícími se mezi 120 a 140 mm Hg STK, potřebou jeho rychlého snížení do 3 měsíců od zjištění hypertenze i tématem kombinované léčby. Ta by měla být nasazena již při zahájení léčby nejlépe kombinací blokátoru systému renin-angiotenzin a blokátoru kalciového kanálu s přidáním diuretika ve 2. kroku a preferenčně s využitím fixních kombinací. Rozebrali také výběr diuretika, kdy se shodli, že indapamid je diuretikum s příznivým metabolickým profilem, dlouhým poločasem a dobrým účinkem na snížení krevního tlaku, které v běžných dávkách vykazuje minimální riziko minerálových dysbalancí. V závěru poukázali na potřebu správného měření tlaku a prokázaný přínos domácího monitoringu krevního tlaku, optimálně spojeného s telemedicínou pro zlepšení kompenzace hypertenze, které by mohlo být, zvláště po zkušenostech z období covidových restrikcí, zavedeno do běžné praxe.

Published: October 25, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Zafarová Z. Sedm otazníků v léčbě hypertenze. Vnitr Lek. 2021;67(Suppl. C - Novinky v k):24-27. doi: 10.36290/vnl.2021.103.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Cífková R, Bruthans J, Wohlfahrt P, Krajčoviechová A, Šulc P, Jozífová M, Eremiášová L, Pudil J, Linhart A, Widimský J Jr, Filipovský J, Mayer O Jr, Škodová Z, Poledne R, Stávek P, Lánská V. 30-year trends in major cardiovascular risk factors in the Czech population, Czech MONICA and Czech post-MONICA, 1985-2016/17. PLoS One. 2020; 15(5): e0232845. Go to original source... Go to PubMed...
    2. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, Chalmers J, Rodgers A, Rahimi K. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387(10022): 957-967. Go to original source... Go to PubMed...
    3. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021-3104. Go to original source... Go to PubMed...
    4. Julius S, Kjeldsen SE, Weber M, Brunner HR, Ekman S, Hansson L, Hua T, Laragh J, McInnes GT, Mitchell L, Plat F, Schork A, Smith B, Zanchetti A; VALUE trial group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004; 363(9426): 2022-2031. Go to original source... Go to PubMed...
    5. Xu W, Goldberg SI, Shubina M, Turchin A. Optimal systolic blood pressure target, time to intensification, and time to follow-up in treatment of hypertension: population based retrospective cohort study. BMJ. 2015; 350: h158. Go to original source... Go to PubMed...
    6. Böhm M, Schumacher H, Teo KK, Lonn EM, Mahfoud F, Mann JFE, Mancia G, Redon J, Schmieder RE, Sliwa K, Weber MA, Williams B, Yusuf S. Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. Lancet 2017; 389(10085): 2226-2237. Go to original source... Go to PubMed...
    7. Wald DS, Law M, Morris JK, Bestwick JP, Wald NJ. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med. 2009; 122(3): 290-300. Go to original source... Go to PubMed...
    8. Dezii CM. A retrospective study of persistence with single-pill combination therapy vs. concurrent two-pill therapy in patients with hypertension. Manag Care. 2000; 9(9 Suppl): 2-6.
    9. Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ. 2008; 336(7653): 1114-1117. Go to original source... Go to PubMed...
    10. Gradman AH, Parisé H, Lefebvre P, Falvey H, Lafeuille MH, Duh MS. Initial combination therapy reduces the risk of cardiovascular events in hypertensive patients: a matched cohort study. Hypertension 2013; 61(2): 309-318. Go to original source... Go to PubMed...
    11. Kjeldsen SE, Oparil S, Narkiewicz K, Hedner T. The J-curve phenomenon revisited again: SPRINT outcomes favor target systolic blood pressure below 120 mmHg. Blood Press 2016; 25(1): 1-3. Go to original source... Go to PubMed...
    12. Jamerson KA. Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension Trial. The first hypertension trial comparing the effects of two fixed-dose combination therapy regimens on cardiovascular events: Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension (ACCOMPLISH). J Clin Hypertens (Greenwich). 2003; 5(4 Suppl 3): 29-35. Go to original source... Go to PubMed...
    13. Burnier M, Bakris G, Williams B. Redefining diuretics use in hypertension: why select a thiazide-like diuretic? J Hypertens. 2019 Aug; 37(8): 1574-1586. Go to original source... Go to PubMed...
    14. Gosse P, Sheridan DJ, Zannad F, Dubourg O, Guéret P, Karpov Y, de Leeuw PW, Palma-Gamiz JL, Pessina A, Motz W, Degaute JP, Chastang C. Regression of left ventricular hypertrophy in hypertensive patients treated with indapamide SR 1.5 mg versus enalapril 20 mg: the LIVE study. J Hypertens 2000; 18(10): 1465-1475. Go to original source... Go to PubMed...
    15. Mengden T, Hernandez Medina RM, Beltran B, Alvarez E, Kraft K, Vetter H. Reliability of reporting self-measured blood pressure values by hypertensive patients. Am J Hypertens. 1998; 11(12): 1413-1417. Go to original source... Go to PubMed...
    16. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, Kario K, Lurbe E, Manolis A, Mengden T, O'Brien E, Ohkubo T, Padfield P, Palatini P, Pickering TG, Redon J, Revera M, Ruilope LM, Shennan A, Staessen JA, Tisler A, Waeber B, Zanchetti A, Mancia G. ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension practice guidelines for home blood pressure monitoring. J Hum Hypertens 2010; 24(12): 779-785. Go to original source... Go to PubMed...
    17. Sega R, Facchetti R, Bombelli M, Cesana G, Corrao G, Grassi G, Mancia G. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005; 111(14): 1777-1783. Go to original source... Go to PubMed...
    18. McManus RJ, Mant J, Franssen M, Nickless A, Schwartz C, Hodgkinson J, Bradburn P, Farmer A, Grant S, Greenfield SM, Heneghan C, Jowett S, Martin U, Milner S, Monahan M, Mort S, Ogburn E, Perera-Salazar R, Shah SA, Yu LM, Tarassenko L, Hobbs FDR. TASMINH4 investigators. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. Lancet 2018; 391(10124): 949-959. Go to original source... Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.