The clinical implication of the target organ protective properties of antihypertensive drugs in new guidelines for the management of arterial hypertension: the benefit of calcium channel blockers and diuretics

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Abstract It is well-known and proven that hypertension-mediated organ damage is about high clinical importance and prognostic significance as well as these end-organ structural and functional impairment are required to be reversed or delayed by antihypertensive treatment. Updated European and Russian guidelines for the management of arterial hypertension once again pay attention to the high prevalence of this disease. These documents also emphasize the priority of combination antihypertensive treatment, which includes, in addition to renin-angiotensin-aldosterone system blockers, calcium channel antagonists and diuretics, as a first-line therapy, indicated for the most patients with hypertension. The recommendations also highlight importance of target-organ damage as a factor contributing to an extremely increase in burden of cardiovascular risk for the patient and playing one of the fundamental prognostic roles in the development of fatal and non-fatal cardiovascular events. In this regard, it is reasonable to stress the powerful target-organ protective potential of the thiazide-like diuretic indapamide and the calcium channel blocker nitrendipine and their unique pharmacological properties, which favorably distinguish each of these antihypertensive drugs within their class and are provided the protection of all hypertension end-organs. The data from randomized clinical trials indicate not only the ability of indapamide and nitrendipine to prevent the development of target-organ damage, but also demonstrate their high potential in reversing such impairment caused by hypertension, which in turn suggests a reduction in cardiovascular risk and improved prognosis for patient during using of these drugs and expands the capabilities of physicians in target-organ protection with antihypertensive treatment.

About the authors

Aleksei I. Kochetkov

Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University

Email: ak_info@list.ru
Cand. Sci. (Med.) Moscow, Russia

Olga D. Ostroumova

Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ostroumova.olga@mail.ru
D. Sci. (Med.), Prof. Moscow, Russia

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