Novas guidelines para o tratamento da HTA

Hello, espero que o fim-de-semana tenha sido revigorante ou então divertido, ou ambas quem sabe :)

Trago até vós a informação de que saíram, fresquinhas, guidelines para o tratamento da hipertensão que podem obter (após registo gratuito) no site da Sociedade Europeia de Hipertensão.

Transcrevo apenas algumas coisas que julguei importantes:

- "Treatment Initiation:

(1) Although trial evidence is scanty, it appears reasonable to recommend that, in grade 1 hypertensives (SBP 140–159mmHg or DPB 90–99mmHg) at low and moderate risk, drug therapy should be started after a suitable period with lifestyle changes. Prompter initiation of treatment is advisable if grade 1 hypertension is associated with a high level of risk, or if hypertension is grade 2 or 3.

(2) In patients with high normal BP (SBP 130–139mmHg or DPB 85–89mmHg) uncomplicated by diabetes or previous cardiovascular events, no trial evidence is available of treatment benefits, except for a delayed onset of hypertension (crossing the 140/90mmHg cutoff).

(3) Initiation of antihypertensive drug therapy in diabetic patients with high normal BP is presently unsupported by prospective trial evidence. For the time being, it appears prudent to recommend treatment initiation in high normal BP diabetic patients if subclinical organ damage (particularly microalbuminuria or proteinuria) is present.

- "Combination therapy:

However, trial evidence of outcome reduction has been obtained particularly for the combination of a diuretic with an ACE inhibitor or an angiotensin receptor antagonist or a calcium antagonist, and in recent large-scale trials for the ACE inhibitor/calcium antagonist combination. The angiotensin receptor antagonist/calcium antagonist combination also appears to be rational and effective. These combinations can thus be recommended for priority use."

Concluindo, vivam as combinações fixas IECA + antagonista dos canais de cálcio.

Bom estágio!