MODERN APPROACHES TO HYPERTENSION TREATMENT: NEW DRUGS AND THERAPEUTIC STRATEGIES

Abstract

The aim of this study is to evaluate current therapeutic strategies for the treatment of arterial hypertension, with a focus on the use of fixed-dose combinations of antihypertensive drugs and treatment escalation in patients with uncontrolled blood pressure. The Novosibirsk Regional Clinical Cardiology Dispensary, which provides specialized care to patients with cardiovascular diseases, was chosen as the study site.

Based on current Russian clinical guidelines for arterial hypertension for 2024 and the European ESH 2025 guidelines, a prospective observation model was developed for 150 patients with stage II–III essential hypertension. Patients were divided into two groups: standard step therapy, primarily using mono- and free-form combinations, and a strategy of early administration of fixed-dose combinations with the active use of modern drug classes and treatment intensification algorithms. Blood pressure dynamics, the frequency of achieving target blood pressure levels, the structure of the pharmacotherapy used, and the frequency of hospitalizations for cardiovascular reasons were assessed.

The study showed that the strategy of early administration of fixed-dose combinations and active treatment intensification is associated with a more pronounced reduction in blood pressure and a higher proportion of patients achieving target values, with comparable tolerability compared to standard step therapy. The obtained results are consistent with current concepts regarding the advisability of the widespread use of fixed-dose combinations, 24-hour blood pressure monitoring, and the consideration of interventional methods (renal denervation) in some patients with resistant hypertension.