Abstract
Hypertension (HT) is the main risk factor for disease and death in the world, and properly controlling it reduces the risk of associated morbimortality. Essential HT is the most common form of HT (90%-95%), and genetic as well as environmental factors are implicated in its development. When considering a therapeutic protocol in a hypertensive patient it is important to quantify the vascular risk and define a control target. Following the 2018 recommendations of the European Society of Hypertension and the European Society of Cardiology, in the majority of cases it is indicated to simultaneously commence with lifestyle modifications and pharmacological treatment. The recommendation is to always start treatment with a combined therapy, except in patients with BP close to the target and in patients who are frail or over the age of 80 years. For the majority of patients a combination of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist II (ARA II) with a calcium antagonist or a thiazide will be preferable, although we should always individualize the treatment and control targets according to the patient's profile, while also considering special situations such as heart failure, auricular fibrillation, heart disease, chronic kidney disease or resistant HT.
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