Abstract
Hypertension is the most prevalent clinical symptom arising from various cardiovascular disorders. Likewise, it is considered a precursor or sequelae to the development of acute coronary artery disease and congestive heath failure (CHF). Hypertension has been considered a cardinal criterion to determine cardiovascular function. According to the World Health Organization (WHO) global observatory data, hypertension causes more than 7.5 million deaths a year, about 12.8% of the total human mortality. Similarly, the Center for Disease Control (CDC) states that 35% of the American adults have been estimated to have a persistently high blood pressure, which makes it about one in every three adults. Hypertension is a modifiable symptom that can be managed through pharmacological and non-pharmacological methods and standard protocols set forth by the American Heart Association (AHA). With new findings from various clinical trials related to the management of hypertension, new developments and recommendations have been made to update the previously established protocols for hypertension. This article aims to discuss and dissect the modern updates of hypertension management as comprehensively elaborated in the 2017 Hypertension Clinical Practice Guidelines.
Highlights
BackgroundHypertension (HTN) is part of a clinical syndrome that results from multifaceted etiologies and can contribute to the development of complex cardiovascular disorders
Calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs), or angiotensinconverting enzyme (ACE) inhibitors [4] have been recommended as the first-line agents [5] for the initiation of pharmacological therapy in a newly diagnosed patient
Five randomized controlled trials RCTs were conducted to determine the best medication therapy and the results showed a superiority of reninangiotensin system (RAS) blockade over calcium channel blockers (CCBs) [6,29]
Summary
Hypertension (HTN) is part of a clinical syndrome that results from multifaceted etiologies and can contribute to the development of complex cardiovascular disorders. Guidelines by AHA, decisions to manage HTN using BP-lowering medications, in addition to nonpharmacological interventions, should be determined by the level of BP and the patient's risk for atherosclerotic cardiovascular disease (ASCVD) [2]. Calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs), or angiotensinconverting enzyme (ACE) inhibitors [4] have been recommended as the first-line agents [5] for the initiation of pharmacological therapy in a newly diagnosed patient. Certain risk factors [7] are to be considered in hypertension, which aids in screening high-risk groups and suggesting appropriate interventions aiding early diagnosis and management According to these guidelines, the recommended goal for adults with HFrEF and HTN is set at 130/80 mmHg [8,9]. Follow-up assessment every month is advised for patients with stage 2 HTN
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