Пульс - медицинский центр 
Пульс - медицинский центр
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The first and mandatory step in the treatment of hypertension is lifestyle modification (LS), which is aimed at correcting the above risk factors, primarily modifiable ones. A big problem is the choice of the most optimal treatment for hypertension, which can slow down the progression of lesions of the heart, blood vessels, kidneys, brain and eyes. The vast majority of hypertensive patients who seek medical help require combination antihypertensive therapy. At the same time, the most appropriate at the present level is the use of fixed combinations of such drugs.
Primary arterial hypertension (AH) or essential hypertension (AH) remains one of the most common cardiovascular diseases. A prolonged and persistent increase in blood pressure (BP) leads to damage to target organs, contributing to the development of severe cardiovascular complications (cerebral stroke, myocardial infarction, life-threatening arrhythmias and heart failure), kidney damage (renal failure) and vision and causes high mortality and disability of the working-age population. Annually in the world hypertension is the cause of death of more than 10 million people. In Ukraine, more than 12.6 million people are registered with this disease, or more than 35% of the population. But, among people with high blood pressure (BP), only 52% of patients know about the presence of the disease, less than a third of them are treated, and no more than 15% of patients are effectively treated.
Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.
The most common diseases associated with hypertension include: obesity, primarily abdominal obesity (AO), type 2 diabetes mellitus (DM), coronary heart disease (CHD), arrhythmias and conduction disorders, chronic kidney disease (CKD), cerebrovascular diseases , joint diseases, chronic obstructive pulmonary disease, sleep apnea syndrome, thyroid disease and other endocrine diseases. In this regard, the 2018 European Society of Hypertension and European Society of Cardiology guidelines emphasized the need for careful stratification of cardiovascular and overall risk of complications in order to select the most optimal antihypertensive therapy.
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