Dr.S.Venkatesan MD
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Management issues in systemic hypertension : Too many choices and too many guidelines !
December 14, 2008 1:12 am
Let us not forget the basics !
- HT management has been made easier with the availability of many good drugs , at the same time it has become a complex issue with as many classification and guidelines.
- The management of HT has evolved over the decades. Now we have realised HT is not a simple number game . Reducing the blood pressure to target levels is not sufficient and is not the primary aim !.
- In fact we now know controlling the numbers alone is never going to work , combined risk factor reduction is of paramount importance.
- HT per se is less lethal but when it combines with hyperlipidemia and diabetes or smoking it becomes aggressive.The blood lipids especially the LDL molecule enjoy the high pressure environment , penetrate and invade the vascular endothelium.
- ASCOT LLA study has taught us, for blood pressure reduction to be effective and reduce CAD events one has to reduce thier lipid levels also.So , for every patient with HT there is not only a target BP but also a target LDL level .
Final message
The tip for better vascular health is , all hypertensive patients should keep their lipids to optimal levels and all hyperlipidemia patients should keep their BP as low as possible .
“Keep your LDL as low as your diastolic blood pressure and let us keep it around 70 -80
Posted by dr s venkatesan
Categories: cardiology -Therapeutics, Cardiology hypertension
Tags: allhat, ascot, atherosclerosis, bmj, coronary artery disese, diastolic blood presssure, hyperlipidemia, hypertension, jacc, jama, lancet, ldl, lipids, mayo clinc, nejm
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