scholarly journals What new will implementation of European Guidelines for managing arterial hypertension introduce into real-life clinical practice?

Kardiologiia ◽  
2019 ◽  
Vol 59 (7S) ◽  
pp. 47-52
Author(s):  
Yu. V. Badin ◽  
I. V. Fomin ◽  
D. S. Polyakov
Keyword(s):  
Arterial Hypertension ◽  
European Society ◽  
Treatment Efficacy ◽  
Representative Sample ◽  
Real Life ◽  
European Part ◽  
Treatment Goals ◽  
European Guidelines ◽  
New Guidelines ◽  
European Society Of Cardiology

Aim. To analyze the effect of introducing new treatment goals in hypertension stated in the 2018 European Society of Cardiology and European Society of Hypertension Guidelines on prevalence and treatment efficacy of arterial hypertension (AH) in a representative sample of patients in the European part of the Russian Federation. Materials and methods. A representative sample of population in the European part of Russia was evaluated in 1998, 2002, 2007, and 2017. The structure of patients with AH was compared in these samples according to the 2013 and 2018 European Guidelines. Results. Introduction of new guidelines for the treatment of AH in 2018 resulted in increasing the prevalence of hypertension from 35.5% to 36.9% in 1998, from 39.1% to 39.9% in 2002, from 451.0% to 41.3% in 2007, and from 43.3% to 43.6% in 2017. Proportion of effectively managed patients decreased from 4.7% to 3.5% in 1998, from 7.5% to 6.2% in 2002, from 17.0 to 14.7% in 2007, and from 30.8% to 26.4%. Proportion of patients who required initiation of antihypertensive therapy increased from 59.6% to 61.1% in 1998, from 47.9% to 49.1% in 2002, from 27.9% to 28.2% in 2007, and from 17.5% to 18.2% in 2017. Conclusion. The new requirements to diagnostic and treatment of AH provided by the 2018 European Society of Cardiology Guidelines insignificantly influenced prevalence and treatment efficacy of AH. At the same time, the new guidelines appeared rather difficult for application due to different values of blood pressure used for diagnostics and treatment goals.

scholarly journals Triple fixed combination for hypertension treatment — a green light in the new european Guidelines 2018

2019 ◽  
Vol 24 (6) ◽  
pp. 716-722
Author(s):  
A. O. Konradi
Keyword(s):  
Combination Therapy ◽  
Arterial Hypertension ◽  
European Society ◽  
Green Light ◽  
Drug Combinations ◽  
Fixed Dose ◽  
Multiple Drug ◽  
Triple Combination Therapy ◽  
European Guidelines ◽  
European Society Of Cardiology

The majority of patients with stable arterial hypertension require combination therapy which is supported by the clinical evidence. The established target levels of blood pressure below 130/80 mmHg are challenging and demand multiple drug combinations in a single patient. Therefore, the use of dual and triple combination therapy is getting wider, and rational triple fixed combinations are highly relevant. The updated guidelines on the diagnostics, management and treatment of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology confirm and recommend early and wider use of the fixed-dose drug combinations. The paper reviews the main practical issues of the use of combination therapy, including key questions of the change from free dose to fixed dose combinations and their rational choice.

scholarly journals GUIDELINES ON ARTERIAL HYPERTENSION MANAGEMENT OF THE EUROPEAN SOCIETY OF CARDIOLOGY AND EUROPEAN SOCIETY OF HYPERTENSION 2018: WHAT’S NEW?

The Clinician ◽  
2018 ◽  
Vol 12 (2) ◽  
pp. 10-15
Author(s):  
A. A. Klimenko ◽  
D. A. Anichkov ◽  
N. A. Demidova
Keyword(s):  
Arterial Hypertension ◽  
European Society ◽  
Beta Blockers ◽  
Ambulatory Monitoring ◽  
White Coat Hypertension ◽  
General Strategy ◽  
Masked Hypertension ◽  
Angiotensin Ii Receptor ◽  
European Society Of Cardiology ◽  
Selection Of

The article considers the key points of the new 2018 guidelines of the European Society of Cardiology and European Society of Hypertension on management and treatment of patients with arterial hypertension (AH). The guidelines widen the possibilities for ambulatory monitoring of blood pressure (BP) and at-home measurement of BP in diagnosis of AH, especially for detection of hidden (“masked”) hypertension and white-coat hypertension. New target ranges for BP depending on age and concomitant pathology are established. For most patients, BP <140 mm Hg (primary target) is accepted, for patients under 65 years if therapy is well-tolerated BP <130 mm Hg should be achieved. Selection of treatment for elderly patients shouldn’t be based on chronological age but on biological age taking into account evaluation of senile asthenia, self-maintenance and therapy tolerability. For starting selection of drugs for AH, in most patients two-component therapy (one pill drug) is preferable. The latest guidelines contain simplified algorithms for management of patients with AH. It is shown that in most patients, a preference should be made for combinations of renin-angiotensin-aldosterone system blocker (inhibitors of angiotensin-converting enzyme or angiotensin II receptor blockers) with a slow calcium channels blocker and/or thiazide/thiazide-like diuretic. Beta-blockers should be prescribed only for specific clinical cases. Special emphasis is made on evaluation of patient’s treatment adherence as the main reason for insufficient BP control, as well as on increased role of nurses and pharmacists in education, monitoring, and support of patients with AH being an important part of general strategy of BP control.

scholarly journals Dart to the target: an alternative bull’s eye parametric display for European Society of Cardiology / European Respiratory Society goal-orientated risk reduction strategy in pulmonary arterial hypertension

2018 ◽  
Vol 8 (3) ◽  
pp. 204589401878052
Author(s):  
Cihangir Kaymaz ◽  
Ozgur Yasar Akbal ◽  
Aykun Hakgor ◽  
Hacer Ceren Tokgoz ◽  
Seda Tanyeri
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Risk Reduction ◽  
European Society ◽  
European Respiratory Society ◽  
Reduction Strategy ◽  
Risk Reduction Strategy ◽  
Pulmonary Arterial ◽  
European Society Of Cardiology ◽  
Bull's Eye

Despite the significant mortality and mobidity benefits being obtained with the targeted therapies in patients with pulmonary arterial hypertension (PAH), mid- to long-term survival of patients with this disease has remained unsatisfactory. For earlier and reliable risk stratification in PAH and tailoring the dynamic management strategies, various risk assessment models have been developed. Currently available risk reduction strategy recommended by the European Society of Cardiology (ESC)/European Respiratory Society (ERS) 2015 Pulmonary Hypertension Guidelines has been utilized in three recent registries. In this review, we evaluated the risk prediction models and management algorithms in this setting and propose an alternative parametric display, a bull’s eye, dart table scheme for ESC/ERS goal-orientated risk reduction strategy in patients with PAH.

scholarly journals 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC)

2013 ◽  
Vol 31 (10) ◽  
pp. 1925-1938 ◽  
Author(s):  
Giuseppe Mancia ◽  
Robert Fagard ◽  
Krzysztof Narkiewicz ◽  
Josep Redán ◽  
Alberto Zanchetti ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Practice Guidelines ◽  
European Society ◽  
European Society Of Cardiology

scholarly journals New АСС/AHA and ESC/ESH arterial hypertension guidelines

2018 ◽  
Vol 17 (5) ◽  
pp. 99-119 ◽  
Author(s):  
E. V. Reznik ◽  
I. G. Nikitin
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
European Society ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
National Guidelines ◽  
Hypertension Guidelines ◽  
European Society Of Cardiology ◽  
Detection Evaluation

The American College of Cardiology and the American Heart Association updated the guideline for the prevention, detection, evaluation and management of high blood pressure in adults in 2017 The European Society of Cardiology and the European Society оf Hypertension updated guidelines for the management of arterial hypertension in 2018. This article reviews new positions of these documents, compares approaches to current issues of managing of the patients with arterial hypertension, pro and contra with previous versions of similar documents. It is necessary to update the National guidelines for management of patients with arterial hypertension, which should include the dignity of both European and American approaches.

scholarly journals Approaches to the Diagnosis and Treatment of Arterial Hypertension in the Light of European Recommendations

Kardiologiia ◽  
2019 ◽  
Vol 59 (9) ◽  
pp. 64-70
Author(s):  
V. N. Larina ◽  
B. Ya. Bart ◽  
E. A. Vartanian ◽  
E. V. Fedorova ◽  
M. P. Mikhailusova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Drug Treatment ◽  
Arterial Hypertension ◽  
European Society ◽  
Initial Therapy ◽  
Ambulatory Bp Monitoring ◽  
Single Pill ◽  
European Society Of Cardiology

In this review we present analysis the European recommendations on hypertension – what’s new and what has changed in the tactics of managing patients with arterial hypertension (AH). We compared recommendations on hypertension of the European Society of Cardiology (ESC) and the European Society of hypertension (ESH) 2018 with European recommendations of previous years. In the updated version of guidelines, it is still recommended to determine AH as blood pressure (BP) ≥140 and / or ≥90 mm Hg; to subdivide BP levels into optimal, normal, and high normal, to classify severity of AH as 3 degrees, and to distinguish separately its isolated systolic form. Values for out-of-office BP remained unchanged, but recommendations emerged concerning wider use of ambulatory BP monitoring and self-measurement of BP. For initial therapy, it was recommended to use two drugs combinations preferably as single pill combinations. An increase of the role of nurses and pharmacists in teaching, supporting patients and controlling hypertension has been noted. This can improve the achievement of target BP and, as a result, reduce the cardiovascular risk. New European recommendations highlight the modern aspects of classification and diagnosis of AH, main stages of screening, and algorithm of drug treatment of AH.

scholarly journals EPOCHA-AH 1998–2017. Dynamics of prevalence, awareness of arterial hypertension, treatment coverage, and effective control of blood pressure in the European part of the Russian Federation

Kardiologiia ◽  
2019 ◽  
Vol 59 (1S) ◽  
pp. 34-42 ◽  
Author(s):  
Yu. V. Badin ◽  
I. V. Fomin ◽  
Yu. N. Belenkov ◽  
V. Yu. Mareev ◽  
F. T. Ageev ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Russian Federation ◽  
Representative Sample ◽  
Antihypertensive Drugs ◽  
Pilot Project ◽  
European Part ◽  
Effective Control ◽  
Treatment Coverage ◽  
The Russian Federation

Aim.To perform a repeated epidemiological study of a representative sample in the European part of the Russian Federation in 2017 and to compare the dynamics of arterial hypertension (AH) prevalence with the effectiveness of blood pressure (BP) control in the population compared to 1998, 2002, and 2007.Materials and methods.A representative sample of the European part of the Russian Federation was created in 2002 and re-examined in 2007 and 2017. In 1998, a pilot project was performed for examining a representative sample for the Nizhniy Novgorod region.Results.During 19 years of follow-up, the AH prevalence increased from 35.5 to 43.3%. Te awareness and treatment coverage reached 76.9 and 79.3%, respectively, in 2017. Achievement of the target BP with a single measurement also increased among patients receiving antihypertensive medication from 14.3 to 34.9%. For the treatment of AH, medium-acting antihypertensive drugs are used, ofen at suboptimal doses.Conclusion.Epidemiological indices of awareness, treatment coverage, and number of effectively managed patients with AH have improved. However, the AH prevalence has increased by 7.8% for 19 years, which indicates inefciency of the primary prevention of this disease.

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