Either the blood pressure is not measured, or the physician fails to react in the face of elevated blood pressure values ( 4), or treatment is not provided optimally, or the patient fails to take the necessary medication regularly ( 5). Even though the epidemiological association between high blood pressure and cardiovascular morbidity and mortality is well known, and despite the fact that sufficient evidence exists to justify antihypertensive treatment ( 3), blood pressure is often not adequately controlled. The declining incidence of stroke in recent decades is accounted for in large measure by the reduction of blood pressure ( 2).

The World Health Organization estimates that 54% of strokes and 47% of cases of ischemic heart disease are the direct consequence of high blood pressure, which thus takes its place among the main risk factors for cardiovascular morbidity and mortality ( 1). Mineralocorticoid-receptor blockers are effective in patients whose blood pressure cannot be brought into acceptable range with first-line drugs.Ĭonclusion: In most patients with essential hypertension, the blood pressure can be well controlled and the cardiovascular risk reduced through a combination of lifestyle interventions and first-line antihypertensive drugs.

The first-line drugs for arterial hypertension include long-acting dihydropyridine calcium channel blockers, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and thiazide-like diuretics. The main non-pharmacological measures against high blood pressure are reduction of salt in the diet, avoidance of excessive alcohol consumption, smoking cessation, a balanced diet, physical exercise, and weight loss. If the treatment is well tolerated, further lowering of blood pressure, with a defined lower limit, is recommended for most patients. According to the current European guidelines, the target blood pressure for all patients, including those with diabetes mellitus or renal failure, is <140/90 mmHg. Further risk factors and end-organ damage should be considered as well. The diagnosis should be confirmed by 24-hour ambulatory blood pressure monitoring or by home measurement. Results: Arterial hypertension is diagnosed when repeated measurements in a doctor’s office yield values of 140/90 mmHg or higher.

Methods: This review is based on pertinent publications retrieved by a selective literature search in PubMed. In Germany, approximately 13% of women and 18% of men have uncontrolled high blood pressure (≥ 140/90 mmHg). Background: Essential arterial hypertension is one of the main treatable cardiovascular risk factors.

Senior blood pressure chart 2018