Combination therapy and better adherence to achieve the new blood pressure targets. The new guidelines of the Hungarian Society of Hypertension for the management of arterial hypertension
PTE KK, II. sz. Belgyógyászati Klinika és Nephrologiai Centrum, FMC Dialízis Centrumok, Pécs
In the new guidelines of the Hungarian Society of Hypertension for the management of arterial hypertension the blood pressure thresholds are unchanged. Out-off office blood pressure measurements and cardiovascular risk stratification is emphasized. Lower target blood pressure ranges are advised than before. Beside lifestyle intervention it is recommended to initiate antihypertensive treatment with two-drug combination, preferably in a single pill combination in almost all hypertensive patients. The most effective combinations in target organ protection are ACEI+calcium channel blocker, ACEI+thiazide-like diuretic/thiazide but there is also considerable evidence on the effectiveness of ARB+ calcium channel blocker, ARB+thiazide-like diuretic/thiazide or calcium channel blocker+thiazide-like diuretic/thiazide combinations. Among diuretics the thiazide-like indapamide is the favourable blood pressure lowering agent. Single pill combinations are advised for the initiation of antihypertensive treatment even in small doses because the adherence is better and there are fewer side-effects. Interventions to increase patients’ adherence are also emphasized.