Treatment of arterial hypertension in clinical practice: Arterial stiffness as a factor influencing the choice of approaches to the antihypertensive therapy

This article addresses the current issues in the treatment of arterial hypertension (AH) in clinical practice. Despite the availability of effective antihypertensive agents, most patients with AH fail to achieve the blood pressure (BP) targets. This situation becomes even more important due to the growing awareness of the need to achieve lower BP readings in a wide range of patients.

This article explores the current evidence supporting the effectiveness of the approach to lowering blood pressure levels and, what can be viewed as being just as important, maintaining these levels over a long period. New data on the role of pulse wave velocity reduction as a factor for assessing the efficacy of antihypertensive therapy are presented. In particular, various components of the pulse wave velocity which change differently with a decrease in blood pressure are discussed. The authors consider the recently reported results from the meta-analysis of randomized clinical trials, which was conducted to find answers to a number of essential questions relating to the management of hypertension in patients with chronic kidney disease (CKD), specifically, whether hypertension treatment strategies in patients with CKD should differ from those in patients without CKD. The current approaches to the choice of optimal antihypertensive therapy determined by new treatment goals for patients with hypertension are reviewed. The advantages of using azilsartan in combination with amlodipine or chlorthalidone, as well as the advantages of angiotensin II receptor blockers in antihypertensive therapy compared to angiotensin-converting enzyme inhibitors are highlighted.

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