Step score

Graduated plan of the medicinal medical treatment:

Shouldn't lead general measures to the success, a therapy recommends itself with antihypertensives with a gradual increase of the number of the different medicines and the dosages so. A medicinal therapy with striving for optimal values is always indexed at patients with diabetes mellitus, kidney illnesses, cardiovascular diseases and others illnesses which unfavorably are influenced by high blood pressure.

Mild hypertension:
90-99 mmHg judge systolically 140-159 mmHg, diastolic: A monotherapy measured out lowly recommends itself to one of the 5 base antihypertensives. The selection goes by individual tolerance and accompanying illnesses:

Beta blocker   Diureticum   Calcium antagonist   ACE inhibitor   Alpha blocker

Moderate hypertension:
100-109 mmHg judge systolically 160-179 mmHg, diastolic: It is aim to bring the blood pressure back to normal with the side effect poorest means. At an inadequate hypotension under monotherapy you shouldn't increase up to the dose maximum since otherwise the side effects also increaseIt therefore recommends itself the dilatation on a two combination. Even if the diagnosis "hypertonus" was made newly, it can be foreseen, however already, that a monotherapy will be promising little the recommendation of the newest guidelines passes, very soon, perhaps already from the beginning with a two combination to get in:

Diureticum plus
Beta blocker   Calcium antagonist   ACE inhibitor   Alpha-blocker

or

Calcium antagonist plus
Beta blocker   ACE inhibitor

Thely different combination possibilities have are differently Strong antihypertensive effect (combinations with ACE inhibitors seem the strongest). The selection goes also here by individual tolerance and accompanying illnesses.

Heavy hypertension:
Judge to be systolic >180 mmHg, diastolic > 110 mmHg: One there is one doesn't add it to a blood pressure normalization after trying out different two combinations appropriate third medicine there, e.g. Diureticum+ ACE inhibitor+calcium antagonist

or one combines further substance groups. Sometimes you must extend even by a 4s or 5s therapy. One goes back to the 5 base antihypertensives first, perhaps then must be enlarged with further substance classes (see above). The selection goes also here by individual tolerance and accompanying illnesses.


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