open access

Vol 14, No 1 (2019)
Guidelines and Clinical Practice — a Discussion Forum for Cardiologists
Published online: 2019-04-10
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Modern treatment for a very high cardiovascular risk patient with arterial hypertension

Filip Dybowski, Małgorzata Lelonek
DOI: 10.5603/FC.2019.0001
·
Folia Cardiologica 2019;14(1):112-119.

open access

Vol 14, No 1 (2019)
Guidelines and Clinical Practice — a Discussion Forum for Cardiologists
Published online: 2019-04-10

Abstract

New ESC/ESH 2018 guidelines for the management of arterial hypertension (AH), once again emphasise the significan- ce of evaluating the total cardiovascular risk in patients with hypertension. Total cardiovascular risk evaluation will de- termine the appropriate medication and the best therapeutic strategy. Combination drug therapy improves adherence, is much more convenient for patients, and is recommended under the new guidelines. Most hypertension patients have hypercholesterolemia. We describe the case of a very high cardiovascular risk patient with AH, in which combination drug therapy (antihypertensive and cholesterol-lowering) proved to be swiftly effective. 

Abstract

New ESC/ESH 2018 guidelines for the management of arterial hypertension (AH), once again emphasise the significan- ce of evaluating the total cardiovascular risk in patients with hypertension. Total cardiovascular risk evaluation will de- termine the appropriate medication and the best therapeutic strategy. Combination drug therapy improves adherence, is much more convenient for patients, and is recommended under the new guidelines. Most hypertension patients have hypercholesterolemia. We describe the case of a very high cardiovascular risk patient with AH, in which combination drug therapy (antihypertensive and cholesterol-lowering) proved to be swiftly effective. 

Get Citation

Keywords

guidelines; arterial hypertension; combination drug

About this article
Title

Modern treatment for a very high cardiovascular risk patient with arterial hypertension

Journal

Folia Cardiologica

Issue

Vol 14, No 1 (2019)

Pages

112-119

Published online

2019-04-10

DOI

10.5603/FC.2019.0001

Bibliographic record

Folia Cardiologica 2019;14(1):112-119.

Keywords

guidelines
arterial hypertension
combination drug

Authors

Filip Dybowski
Małgorzata Lelonek

References (20)
  1. Williams B, Mancia G, Spiering W, et al. ESC Scientific Document Group . 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021–3104.
  2. Zdrojewski T, Jankowski P, Bandosz P, et al. [A new version of cardiovascular risk assessment system and risk charts calibrated for Polish population]. Kardiol Pol. 2015; 73(10): 958–961.
  3. Czarnecka D, Stolarz-Skrzypek K, Bednarski A, et al. Therapeutic strategies in poorly controlled hypertension in outpatient setting in Poland — POSTER study. Folia Cardiol. 2015; 10(4): 242–248.
  4. Jackson R, Lawes CMM, Bennett DA, et al. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual's absolute cardiovascular risk. Lancet. 2005; 365(9457): 434–441.
  5. Zdrojewski T, Solnica B, Cybulska B, et al. Prevalence of lipid abnormalities in Poland. The NATPOL 2011 survey. Kardiol Pol. 2016; 74(3): 213–223.
  6. Sever PS, Dahlöf B, Poulter NR, et al. ASCOT Investigators, ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial — Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003; 361(9364): 1149–1158.
  7. Gupta A, Mackay J, Whitehouse A, et al. Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy study: 16-year follow-up results of a randomised factorial trial. Lancet. 2018; 392(10153): 1127–1137.
  8. Prejbisz A, Klocek M, Gąsowski J, et al. Factors associated with resistant hypertension in a large cohort of hypertensive patients: the Pol-Fokus study. Pol Arch Med Wewn. 2015; 125(4): 249–259.
  9. Athyros VG, Tziomalos K, Katsiki N, et al. GREACE Study Collaborative Group. The impact of smoking on cardiovascular outcomes and comorbidities in statin-treated patients with coronary artery disease: a post hoc analysis of the GREACE study. Curr Vasc Pharmacol. 2013; 11(5): 779–784.
  10. Chapman RH, Benner JS, Girase P, et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med. 2005; 165(10): 1147–1152.
  11. Awad K, Serban MC, Penson P, et al. Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis. J Clin Lipidol. 2017; 11(4): 972–985.e9.
  12. Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012; 125(9): 882–887.e1.
  13. Wiśnowska B, Skowron A. Ocena przestrzegania zaleceń lekarskich w terapii hipercholesterolemii. Farm Przegl Nauk. 2009; 11: 42–47.
  14. Wiśniowska B, Skowron A. Evaluation of patients' adherence to statins in Poland. Curr Med Res Opin. 2011; 27(1): 99–105.
  15. Pan F, Chernew ME, Fendrick AM. Impact of fixed-dose combination drugs on adherence to prescription medications. J Gen Intern Med. 2008; 23(5): 611–614.
  16. Rubba P. Effects of atorvastatin on the different phases of atherogenesis. Drugs. 2007; 67(Suppl 1): 17–27.
  17. Mason RP. Mechanisms of plaque stabilization for the dihydropyridine calcium channel blocker amlodipine: review of the evidence. Atherosclerosis. 2002; 165(2): 191–199.
  18. Ferrari R. Optimizing the treatment of hypertension and stable coronary artery disease: clinical evidence for fixed-combination perindopril/amlodipine. Curr Med Res Opin. 2008; 24(12): 3543–3557.
  19. Sever P, Dahlöf B, Poulter N, et al. ASCOT Steering Committee Members. Potential synergy between lipid-lowering and blood-pressure-lowering in the Anglo-Scandinavian Cardiac Outcomes Trial. Eur Heart J. 2006; 27(24): 2982–2988.
  20. Huffman MD. The polypill: from promise to pragmatism. PLoS Med. 2015; 12(8): e1001862.

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