Selecting optimum antihypertensive therapy

Abstract

The identification of optimum antihypertensive therapy represents the ‘holy grail’ of the management of arterial hypertension. Despite however the numerous attempts to identify accurate predictors of blood pressure response to a specific drug, the discovery of optimum therapy for the individual patient looks like a hopeless quest of hope. Up to now, attempts have been either unsuccessful or difficult to apply in everyday clinical practice. This chapter aims to present the therapeutic strategies for the management of arterial hypertension (stepped-care, sequential monotherapy, individualized, renin-based, hemodynamic), and critically discuss each approach highlighting its advantages and disadvantages. Moreover, several practical recommendations are provided on the build-up of optimum antihypertensive therapy in individual patients.