Rola farmaceuty w profilaktyce i leczeniu nadciśnienia tętniczego
Role of pharmacist in prophylaxis and treatment of artelial hypertension on the background of newest guidelines. Hypertension is one of most common cardiovascular disorders. It affects about 8 million people in Poland. The correlaton between blood pressure values and cardiobascular risk is well documented. It is strong, gradual, progressive, independent and predictable. Numerous, well-designed, large-scale clinical trials clearly showed that lowering blood pressure decreases cardiovascular morbidity and mortality. The same results were obrtained without regard to country, age, sex, race, BP values or socioeconomic factors. They also suffiiciently justify the need for therapy. In 2003 both American (JNC VII Report) and European (ESH/ESC) cardiological and hypertension societies issued their guidelines for hypertension. JNC VII and ESH/ESC update the current knowledge on diagnosis and treatment in hypertension. Discrepancies between these documents pertain to minor issues, such as new trends in hypertension research (post-inflammatory factors, genetic mutations). JNC VII underscores the results of ALLHAT, expanding the indications for thiazide diuretics, which was not brought to light by European experts. Good knowledge of both documents dealing with diagnosis, prophylaxis and therapy of hypertension helps solve clinical problems connected with e.g. expected blood pressure values after treatment, diuretics in initial therapy, indications for monotherapy with drugs from particular groups, management of hypertension in diabetics and patients with chronic kidney disease. The sets of guidelines are also a reliable source of information on prophylaxis, diagnosis and monitoring of hypotensive therapy, which is closely connected with the issue of general pharmaceutical supervision of the hypertensive patients.