To address the critical questions you may encounter during the start of hypertension treatment, our experts share their insights in a mini symposium chaired by Professor Reinhold Kreutz (Germany) and Professor Alta Schutte (Australia) at the ESH-ISH 2021 Joint Meeting On-Air.

Setting the scene for the discussion, Professor Alta Schutte reiterated that ideally single pill combination (SPC) therapy is the first-line treatment for most hypertensive patients when possible and available.1

SPC therapy:

  Improves BP control2,3

  Improves treatment adherence and persistence2,4

  Simplifies treatment approach1

Questions at the Start of Hypertension Treatment

ACE inhibitors and ARBs are the backbone of anti-hypertensive therapy1

2018 ESC/ESH hypertension guidelines recommend ACE inhibitor or ARB (both RAASi) antihypertensive agents for initial dual combination therapy and as part of the 2nd step triple combination therapy in various settings1

This combination strategy applies for hypertensive patients with1:

  • Uncomplicated hypertension
  • CAD
  • AF
  • Heart failure

The RAASi are also recommended for CKD patients, particularly ARB therapy in T2DM patients with nephropathy as indicated by the IDNT trial5,6

Patients with grade 1 hypertension, young adults (<50 y.o.) with low to moderate CV risk, high-normal blood pressure with CAD, pregnant and menopausal women and frail elderly patients can benefit from antihypertensive monotherapy7

All 5 hypertensive drug class are eligible for monotherapy, HCPs choice depends on the patient’s present condition7

Confirmation of BP diagnosis and ABPM should be performed to assess effectiveness of monotherapy

Patients with suspected grade 2 hypertension, young patients (<40 y.o.) with grade 2 hypertension, severe uncontrolled hypertension, resistant hypertension, sudden onset of hypertension and hypertension-mediated organ damage should be referred to specialists as recommended by the 2018 ESC/ESH guidelines1

Patients with primary aldosteronism, sleep apnea, atherosclerotic CVD, or other concomitant conditions that cause hypertension should also be evaluated by a specialist1

Select the right antihypertensive therapy for the right patient at the start, to help patients achieve blood pressure control

The webinar was intended for healthcare professionals (HCPs) only. The views and opinions expressed during the webinar are of the expert and not necessarily endorsed by Sanofi . Please consult the prescribing information in your country of practice current to the date of viewing this content, in respect to medicinal products mentioned in this webinar as information may vary from country to country.

Abbreviations: HCP, healthcare professional; SPC, single pill combination; ESH-ISH, European Society of Hypertension-International Society of Hypertension; ACE-i, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor blocker; ESC/ESH, European Society of Cardiology/European Society of Hypertension; CAD, coronary artery disease; T2DM, type 2 diabetes mellitus; CKD, chronic kidney disease; CV, cardiovascular; RAASi, Renin-angiotensin-aldosterone system inhibitors; BP, blood pressure; ABPM, ambulatory blood pressure monitoring

References: 1. Williams B, et al. Eur Heart J. 2018;39(33):3021-3104. 2. Gupta AK, et al. Hypertension. 2010;55(2):399-407. 3. Egan BM, et al. Hypertension. 2012;59(6):1124-1131. 4. Du LP, et al. J Clin Hypertens (Greenwich). 2018;20(5):902-907. 5. Lewis EJ, et al. N Engl J Med. 2001;345(12):851-860. 6. Parving HH, et al. N Engl J Med. 2001;345(12):870-878. 7. Volpe M, et al. Int J Cardiol. 2019;291:105-111.

For Healthcare Professionals Only