Publication details
Léčba hypertenze u nemocných s ischemickou chorobou srdeční
| Title in English | Treatment of hypertension in patients with ischaemic heart disease |
|---|---|
| Authors | |
| Year of publication | 2010 |
| Type | Article in Periodical |
| Magazine / Source | Postgraduální medicina |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | farmacotherapy; myocardial infarction |
| Description | Hypertension is one of the major risk factors for ischaemic heart disease and good blood pressure control is the basis of primary and secondary prevention of ischaemic heart disease. In primary prevention it is recommended to control blood pressure effectively, i. e., to achieve values of < 140/90 mmHg, reduction lower values is not supported by evidence from clinical trials. Recent data show that in secondary prevention systolic blood pressure suitable for ischemic patients is 130-139 mmHg and diastolic should not fall below 70 mmHg. Hypertension very often occurs with other risk factors and may form a so-called metabolic syndrome. The basis of hypertension treatment in patients with ischaemic heart disease are blockers of the renin angiotensin axis - ACE inhibitors and AII antagonists, eventually direct renin blockers, supplemented by beta blockers, in case of intolerance verapamil. ACE inhibitors are administered on the basis of data from studies HOPE, EUROPA and PEACE, and studies in heart failure. AII antagonists proved to be as effective as ACE inhibitors in comparative trials. Antiplatelet and hypolipidemic treatment must be initiated in each patient. Data from the BRNO registry show a good standard of pharmacotherapy after myocardial infarction, when therapy is close to the recommended optimal treatment for almost 90% of patients. |