Hypertension and nephrology

[Threshold for drug treatment of hypertension target values ​​in the most important therapeutic guidelines]

KÉKES Ede1, VÁLYI Péter2, NAGY Judit3

JUNE 24, 2021

Hypertension and nephrology - 2021;25(03)

DOI: https://doi.org/10.33668/hn.25.013

[Start medication and choose the right target are crucial today - with the aging of the world’s population together - the occurrence of high blood pressure, which is clearly considered a public disease in order to curb it. This also means that the recommendations are justified age-disaggregated and segregated between 18 and 65 years old, the elderly and the very elderly hypertensives. In the latter, it is not just prevalence rate has increased significantly, but also to be reckoned with the incidence of cognitive dysfunction, physical inactivity and common comorbidities, and also with side effects due to polypragmatism. We show it with all this in mind recommendations for the most important guidelines for the treatment of hypertension - also the Hungarian Hypertension Society -, pointing to the corresponding / similar guidelines.]

AFFILIATIONS

  1. 1Pécsi Tudományegyetem, Klinikai Központ, Kardiológiai Tanszék, Pécs
  2. 2VALYTERÁPIA Egészségügyi és Szolgáltató Bt., Győr; Érgondnok Rendelőház, Sopron
  3. 3Pécsi Tudományegyetem, Általános Orvostudományi Kar, II. Belgyógyászati Klinika, Nefrológiai, Diabetológiai Centrum, Pécs

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[Treatment of renal osteodystrophy (ROD) is one of the new osteoporosis recommendations requires a rethink of the current therapeutic approach. Addressing vitamin D deficiency and reducing quality of life deterioration caused by bone fractures it is also an important professional challenge in the renal insufficiency population. ROD is a classic nephrological treatment to improve the results of the newer molecular expected from better understanding of pathomechanisms and better imaging methods. Associated associations with vascular calcification are cardiovascular can help our efforts to prevent complications, a relationship with periodontal disease the importance of regular monitoring supports. In addition to phosphorus binders, vitamin D agonists and calcimimetics in the future is expected to be the resorption inhibitor denosumab, the bone-building processes supporting PTH analogues and the wider clinical use of romosozumab application.]

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[The treatment of obesity is a complex process, the elements of which are lifestyle change (diet and exercise), psychic driving, medication and need in case of surgical treatment. The Hungarian Society of Obesitology and Movement Therapy the first half year of the weight loss program is low in carbs and elevated suggests a protein-rich diet. When designing physical activity, dynamic, aerobic (eg walking, walking, jogging, swimming, cycling, etc.) are recommended. In drug therapy, orlistat, naltrexone / bupropion, is fixed combination and liraglutide play a role. Bariatric surgery they are currently most effective in the short- and long-term treatment of obesity.]

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[A well-designed blood collection site is suitable for hemodialysis (HD-) treatment basis. Even today, kidney replacement therapy is one of the biggest the challenge is to design the right place to bleed and its - during regular HD treatments - long-term preservation. If the previously established blood collection site is bad functioning, removal of uraemic end products would be insufficient the patient’s uraemic condition worsens and his typical symptoms develop Who. In case all is already possible blood site was exhausted, then hemodialysis itself nor can it be sustained further, which is rarely even kidney failure it can also lead to the death of a patient. Hemodialysis patients are hospitalized uptake is more than 20% related to the site of blood collection complications.]

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