Hypertension, the risks differ depending on age

European experts at the International Congress of the European Society of Hypertension (ESH) and of the International Society of Hypertension (Ish) are also new regimens that family physicians can use to treat the medical condition. Studied 12 different cardiovascular problems in various age groups

Hypertension

The consequences that hypertension can have on cardiovascular health change depending on the type of pressure and age. For example, those with a higher maximum pressure have an increased risk of intracerebral hemorrhage, and subarachnoid hemorrhage stable angina, while the so-called higher minimum entails a greater risk of abdominal aortic aneurysm. To say it is a recent British study published in The Lancet and presented today at the congress of the European society of hypertension (ESH) and of the International Society of Hypertension (Ish), taking place in Athens until June 16.

Research. This is the first study that explores the effects of blood pressure on the risk of cardiovascular problems in a variety of 12 different age groups. The researchers examined the pressure data using electronic health records of one million three hundred patients without evident cardiovascular disease and aged 30 years and older, followed for an average of five years from their general practitioner to the first cardiovascular event . During follow-up, the researchers recorded 83 098 cases of beginning of some cardiovascular disease. In each age group, the lowest risk of cardiovascular disease has been detected in people with systolic blood pressure equal to 90-114 mmHg and diastolic blood pressure between 60 and 74 mmHg.

The age factor. The results showed that even when it is treated and kept under control, hypertension remains a constant threat throughout their lives. For example, a thirty year old hypertensive presents a major cardiovascular risk by 63% compared to 46% of a normotensive and develops a cardiovascular disease 5 years prior. Not only that, the study shows that there are different types of hypertension in different stages of life with different cardiovascular effects.

The different stages of life. At 30 years due to untreated hypertension in 43% of cases, stable and unstable angina, while at 80 causes in 19% of cases, heart failure. Treating hypertension from an early age. Experts discuss for a long time about whether to treat patients with mild hypertension, but now this study provides new evidence to support the argument of those who believes it is useful to treat even mild hypertension in younger patients. "Our data provide important information that can improve decision-making in the treatment of hypertension, stratificandolo according to age groups in which the pressure begins to rise and diseases where the risk is higher," said Eleni Rapsomaniki Institute farr for health informatics research in London and co-author of the study.

The problem of adherence to therapy. But at any age, the problem remains untreated hypertension. Despite the wide availability of effective antihypertensive drugs, only 37% of hypertensive patients has been monitoring the pressure. "The biggest challenge is represented by those patients treated with various regimens has not been reached or maintained control of blood pressure" made its debut at the congress in Athens Professor Roland Schmieder, Department of Nephrology and Hypertension, University Hospital Erlangen German ( Nuremberg) during an event organized by Daiichi Sankyo. One of the main causes of this failure is the result of poor adherence to therapy: "Patients benefit of antihypertensive therapy only when strictly follow the prescription, but the reality," he said Schmieder, "is that this rarely happens, and this makes the percentage of long-term success generally low. "

New regimens. Just for groped to improve adherence to currently available therapies, the European experts meeting in Athens have presented new regimens useful to general practitioners for the management of hypertension. Up to now in several clinical trials, the strategy that has proved more fruitful to solve the problem of efficacy and adherence to therapy is linked to the simplification of treatment, with a reduction in the number of daily dosing of drugs: "Currently based therapies are available in fixed combination tablets, effective and well tolerated, improving adherence and simplify the treatment, "said Professor Massimo Volpe, Director of the Unit Complex of Cardiology at the Sant'Andrea Hospital in Rome . Treatment regimens developed by European experts reported the use of an inhibitor of the angiotensin II receptor blocker (ARB) olmesartan taken individually or as associated with the calcium channel blocker (CCB) amlodipine and / or hydrochlorothiazide.

A new approach. These schemes are not an algorithm or a guideline, but represent an attempt to apply the results of clinical trials to everyday practice. "This approach outlines the most appropriate therapy for patients with varying characteristics and needs, and is based on evidence and clinical experience, guidelines and best practices," said the Italian specialist. "Although it can be applied to any inhibitor and angiotensin II receptor, for practical reasons we used olmesartan, a drug because it is available in many European countries both in two fixed dose combination with amlodipine or triple with amlodipine and hydrochlorothiazide." Then use the appropriate therapy in a single tablet regimens identified by might help patients improve adherence and achieve BP targets recommended.