[Initial management of arterial hypertension]

Abstract

Systemic arterial hypertension is currently defined by a systolic BP or a diastolic BP higher than 140/90 mmHg. There are about 8 million hypertensives in France. The diagnosis of arterial hypertension can be made in some cases using ambulatory BP recording or home self BP measurement. The associated risk factors have to be identified, as well as target organs damage (heart, brain, kidney, great vessels). Arterial hypertension is most often mild or moderate. A specific etiology is found in less than 5% of the patients. The goal of therapy is usually a clinic BP lower than 140/90 mmHg (130/80 in patients with diabetes or renal failure). Monotherapy results in a well-controlled BP in 50% of the cases, only. Then, hypertensive patients should be often given 2 or 3 drugs.