[New therapeutic outlooks in the treatment of the hypertensive patient]. / Nuove prospettive terapeutiche nel trattamento del paziente iperteso.

ABSTRACT

The results of the large randomized trials in which antihypertensive drugs have been compared to placebo demonstrated that antihypertensive therapy reduces cardiovascular and cerebrovascular mortality and morbidity. Nowadays, however, it is not enough to lower blood pressure; the goal of the treatment should be to prevent progression of the underlying atherosclerotic disease, reduce major and minor complications and improve survival and quality of life. Furthermore, primary prevention and risk reduction in hypertensives are dependent not only on the antihypertensive effect of the chosen agent, but also on improved detection and management of the other cardiovascular risk factors. The potential ability of antihypertensive treatment to exert an effect on global cardiovascular risk profile has become one of the most important considerations in the selection of an antihypertensive treatment. Thus, in patients at risk for coronary events it seems important to choose a drug or drug combination with a documented effect on coronary events. In addition, both prevention of cardiovascular events and prevention of organ damage and organ disease have to be considered essential goals of antihypertensive therapy. The prevention of organ damage associated with hypertension has also been facilitated by the development of effective antihypertensive drugs. These agents have been shown to have a beneficial influence on organ damage in hypertensive patients through an effective, continuous, smooth control of blood pressure and through specific effects on some of the functional and structural alterations induced by hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)