Med. praxi. 2011;8(12):500-508

Management of hypertension in specific settings and in the presence of comorbidities

prof.MUDr.Jan Bultas, CSc.

Ústav farmakologie 3. LF UK, Praha

The management of hypertension lies largely in the hands of the general practitioner, with an occasional need to seek the help of a specialist.

However, the primary care physician must treat a patient who has many comorbidities with their own specific features. An optimal therapeutic

approach to a hypertensive patient is determined by a number of factors: age, comorbidities, actual level of blood pressure, medications for

comorbidities, patient compliance and numerous other factors. The selection of the most appropriate drug which will best contribute to improving

the patient’s prognosis and, at the same time, will be well tolerated, depends on recognizing and observing these factors. The present

paper presents the current views on the management of hypertension in the elderly, diabetics, nephrological patients and cardiac patients

with heart failure or valvular heart disease, and on the management of hypertension in pregnancy or in those with resistant hypertension

or with hypertensive crisis. The above-mentioned may suggest that the management of hypertension is something of a puzzle for doctors;

fortunately, however, basic principles can be applied to the majority of situations and relatively few drugs are required. Nevertheless, there

are significant differences even among commonly used antihypertensive drugs not only between classes, but also within drug classes.

hypertension.

Keywords: arterial hypertension, pharmacotherapy, diabetes mellitus, heart failure, valvular heart disease, pregnancy, resistant

Published: December 15, 2011  Show citation