Had care of arterial hypertension patients been advanced in 2021?

Arterial hypertension (AH) is a very common disease with increasing incidence and prevalence. AH becomes worldwide the main preventable cause of the preventable deaths. Therefore, it is very important to obtain early diagnose and convenient treatment. Still high cardiovascular mortality in Slovakia, where we have a position at the tail compared to other European countries, very closely related to the failure to obtain treatment blood pressure (BP) target ranges. AH rarely occurs in isolation, and often clusters with other CV risk factors such as dyslipidemia and obesity. 2018 ESC/ESH Guidelines for the management of arterial hypertension has brought several new concepts how to manage arterial hypertension. However, it is important to implement the recommendations of the European Society of Cardiology to everyday clinical practice in each country.

What is a risk heart rate at various stages of the cardiovascular continuum?

Prevention, detection, and treatment of high blood pressure remain an important public health challenge. There is convincing evidence that heart rate is an important risk factor for cardiovascular disease. Recommendations for the resting heart rate measurement are roughly the same as those used for blood pressure measurement which is usually made during the same session. Across different parts of the cardiovascular disease continuum, different heart rate thresholds are identified. Elevated heart rate identifies patients with hypertension at high cardiovascular risk. One of the important causes of inadequate blood pressure control and at the same time heart rate control is the poor adherence of patients to treatment. It is necessary to individualize the treatment of patients with elevated heart rates throughout the cardiovascular continuum. Fixed-dose combination decreases the risk of medication non-compliance and should be considered in patients with chronic conditions like hypertension for improving medication compliance which can translate into better clinical outcomes.

The use of single-pill combinations as first-line treatment for hypertension: translating guidelines into clinical practice.

: The 2008 European Society of Cardiology/European Society of Hypertension guidelines recommend the first-line prescription of two antihypertensive drugs in single-pill combinations (SPCs), also known as fixed-dose combinations, for the treatment of most patients with hypertension. This recommendation is based on a large amount of data, which shows that first-line treatment with SPCs supports reaching blood pressure targets rapidly and reducing cardiovascular outcome risk while keeping the therapeutic strategies as simple as possible and fostering adherence and persistence. As this approach constitutes a big shift from the stepped-care approaches that have been dominant for many years, practicing physicians have expressed concerns about using SPCs as first-line agents. In this review, we will discuss the barriers to the uptake of this recommendation. We will also offer suggestions to reduce the impact of these barriers and address specific concerns that have been raised.

The myths and facts about arterial hypertension: do we really know everything about arterial hypertension?

Arterial hypertension is one of the most commonly underestimated diseases. At the same time various myths are frequently associated with this illness. Likewise, the overload of available clinical data causes misconceptions, which then lead to the misinterpretation of real and also doubtful issues. Unfortunately, these misconceptions result in insufficient blood pressure control. Lets sort through some common myths in our article, so you can make health decisions in the management of hypertension based on the facts.

Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone?

AIM: The aim of this study was to determine the prevalence of erectile dysfunction (ED), testosterone deficiency syndrome (TDS), and metabolic syndrome in patients with abdominal obesity (AO) and the prevalence of morbidity at different levels of testosterone (TST). BACKGROUND: Male sex hormones play an important role in ED and variety of TDS and may have influence on the development of metabolic syndrome. The number of men with AO which constitutes a serious health risk is continuously growing. Currently, there are different views that TST levels are already insufficient, and the patient should benefit from treatment. OBJECTIVES: This study examined the association between ED, testosterone level and metabolic syndrome in men with AO. DESIGN, SETTING, AND PARTICIPANTS: The study was carried out in an outpatient urology center of Urology Clinic and Obesity Center of the Clinic of Internal Medicine. There were 167 participants­men with AO which were examined as part of preventive examination. METHODS: Hormonal, a complete urological and internal evaluation was carried out in every patient. RESULTS AND LIMITATIONS: We found some degree of ED in 73% (122/167) in men with AO. The TST levels below 14 nmol/l had of these 122 patients 84 patients (68.9%) and 49 patients (40.2%) below 10 nmol/l. In this group of patients, we found 103/167 patients (61.7%) with metabolic syndrome. When we compared TST level and morbidity, we found significantly more patients with diabetes mellitus (DM), hypertension and dyslipidemia in group with TST below 10 nmol/l. We also found difference in the levels of HDL cholesterol and triglycerides in the group of patients with TST 10­14 and over 14 nmol/l. CONCLUSION: Patients over 40 years of age with AO and ED should also be examined for TDS and metabolic syndrome. In this group of patients we found that 113/167 patients (67.6%) had total TST below 14 nmol/l, and sufficient level of TST seems to be above this level.