RESUMO
Modern treatment of arterial hypertension (AH) in based on concept of necessity of arterial pressure (AP) lowering to target levels for prevention of cardiovascular (CV) diseases (D) and reduction of cardiovascular mortality. AP <140/90 and <140/80-85 mm Hg are target levels for general population and patients with diabetes, respectively. Most patients should be initially prescribed combination therapy as in ambulatory practice mainly patients from high and very high risk groups are observed. Prescribing combination therapy one should take into consideration not only category of risk of CVD development but also AP level, i.e. degree of AH. It is not expedient to always start combination therapy with low doses of preparation because administration of such therapy in patients with 2-3 degree AH inevitably leads to necessity of further elevation of doses and lengthening of time to achievement of target AP. It should be mentioned that achievement of target AP is possible with continuation of therapy with higher dose of same combination without addition of third drug. Rational pharmacotherapy of AH implies concentration of efforts on consideration of not only AP but also of factors of risk of development of CV complications (C) especially on detection of symptomless target organs damage and clinical complications for assessment of total of CVC development because of recent update of data on prognostic significance of symptomless damage of target organs including heart, blood vessels, kidney, eyes, and brain.
