THE SIGNIFICANCE OF ARTERIAL-HYPERTENSION FOR CONGESTIVE-HEART-FAILURE

Hypertension is, besides coronary artery disease, a main cause of hear t failure (in about 40% of patients). About 20% of the adult German po pulation are hypertensive. Increases in diastolic blood pressure by ab out 5 mmHg increase the risk of stroke or coronary heart disease by ab out 34% or 21%, respectively. As a cardiovascular risk factor systolic hypertension is suggested to be at least as important as diastolic hy pertension. Left ventricular hypertrophy is an independent cardiovascu lar risk factor. Treatment of hypertension is first by general measure s (weight loss, low-sodium diet, changes in lifestyle), and if necessa ry by means of antihypertensive therapy with a diuretic, beta receptor antagonist, calcium antagonist, or converting-enzyme inhibitor. Recen t studies using thiazide diuretics gave support to the use of diuretic s as a first line treatment of hypertension especially in patients wit h isolated systolic hypertension or in elderly patients.