Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients
Hypertension is a major contributor to cardiovascular morbidity and mortality. However, blood pressure control in clinical practice still falls short of treatment recommendations. The reasons for this are manifold, and patient non-compliance with medication has been identified as one important facto...
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| Format: | Article |
| Language: | English |
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AOSIS
2011-11-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/1765 |
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| author | E. van der Merwe A. Carboni |
| author_facet | E. van der Merwe A. Carboni |
| author_sort | E. van der Merwe |
| collection | DOAJ |
| description | Hypertension is a major contributor to cardiovascular morbidity and mortality. However, blood pressure control in clinical practice still falls short of treatment recommendations. The reasons for this are manifold, and patient non-compliance with medication has been identified as one important factor. In this article, we discuss the various reasons for patient noncompliance and look at strategies to improve adherence, for example, simplifying the medication regimen and reducing side-effects in an asymptomatic disease such as hypertension. In this regard, combination treatment, and specifically fixeddose combinations, have come a long way in enhancing tolerability, reducing counter-regulatory drug mechanisms and bringing blood pressure closer to target. We investigate the possibility of some combinations having clinical benefits beyond blood pressure control, as this may improve long-term cardiovascular outcomes. On the other hand, certain combinations may only have positive clinical outcomes in carefully selected patient groups, and are not recommended for the routine management of hypertension. Lastly, issues such as escape mechanisms in the renin-angiotensin-aldosterone system (RAAS) are discussed. These mechanisms play a role in treatment failure, and may require the use of new antihypertensive drug classes, such as direct renin inhibitors. |
| format | Article |
| id | doaj-art-a3c62775c6d949f39fdc0b7a36ff3f91 |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2011-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-a3c62775c6d949f39fdc0b7a36ff3f912025-08-20T03:47:11ZengAOSISSouth African Family Practice2078-61902078-62042011-11-0153610.1080/20786204.2011.108741464606Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patientsE. van der Merwe0A. Carboni1MedikreditPrivate PracticeHypertension is a major contributor to cardiovascular morbidity and mortality. However, blood pressure control in clinical practice still falls short of treatment recommendations. The reasons for this are manifold, and patient non-compliance with medication has been identified as one important factor. In this article, we discuss the various reasons for patient noncompliance and look at strategies to improve adherence, for example, simplifying the medication regimen and reducing side-effects in an asymptomatic disease such as hypertension. In this regard, combination treatment, and specifically fixeddose combinations, have come a long way in enhancing tolerability, reducing counter-regulatory drug mechanisms and bringing blood pressure closer to target. We investigate the possibility of some combinations having clinical benefits beyond blood pressure control, as this may improve long-term cardiovascular outcomes. On the other hand, certain combinations may only have positive clinical outcomes in carefully selected patient groups, and are not recommended for the routine management of hypertension. Lastly, issues such as escape mechanisms in the renin-angiotensin-aldosterone system (RAAS) are discussed. These mechanisms play a role in treatment failure, and may require the use of new antihypertensive drug classes, such as direct renin inhibitors.https://safpj.co.za/index.php/safpj/article/view/1765blood pressure controlcardiovascular outcomeshypertensive patientsrenin angiotensin aldosterone systemraasdirect renin inhibitors |
| spellingShingle | E. van der Merwe A. Carboni Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients South African Family Practice blood pressure control cardiovascular outcomes hypertensive patients renin angiotensin aldosterone system raas direct renin inhibitors |
| title | Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| title_full | Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| title_fullStr | Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| title_full_unstemmed | Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| title_short | Strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| title_sort | strategies to improve blood pressure control and cardiovascular outcomes in hypertensive patients |
| topic | blood pressure control cardiovascular outcomes hypertensive patients renin angiotensin aldosterone system raas direct renin inhibitors |
| url | https://safpj.co.za/index.php/safpj/article/view/1765 |
| work_keys_str_mv | AT evandermerwe strategiestoimprovebloodpressurecontrolandcardiovascularoutcomesinhypertensivepatients AT acarboni strategiestoimprovebloodpressurecontrolandcardiovascularoutcomesinhypertensivepatients |