[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothia­zide and indapamide, and their combination drugs in Hungary.]

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

[In this paper I summarise the currently valid guidelines for the pharmacotherapy of hypertensive patients, and in separate part, those for hypertensive urgencies and emergencies.]

[Background: Current European guidelines on the management of hypertension suggests a simple and easily applicable therapeutic strategy to increase effectiveness. Important component of this strategy is the application of single-pill combination (SPC) of RAS inhibitor in combination with calcium antagonists or diuretics as a first step. Primary objective: To assess the percentage of patients reached goal blood pressure ranges after 12 weeks of fix dose combination therapy with telmisartan plus amlodipine according to office blood pressure measurements in hypertensive patients treated by general practitioners (GPs). Patients and methods: After informed consent, 729 patients of 63 GP’s office participated in this multicentre, non-interventional, prospective data collection study. The intention-to-treat (ITT) population was 717, and primary endpoint was analysed in 690 patients (per protocol [PP] population). There were two visits during the study. Blood pressure was measured in all patients at the time of the enrollment and at the second and final visit. Results: The average age of the patients was 62±12 years, 55% of the patients were younger than 65 years, 357 patients (49.8%) of the population was male. The average office blood pressure at baseline was 150±17/88±10 mmHg, and decreased to 130±8.1/78±6.1 mmHg at 12 week (p<0.05). Pulse rate has decreased as well (from 80±9.8 /min to 75±6.3/min). At baseline 10.1% of the patients were at optimal systolic blood pressure goal, 15.8% at optimal diastolic blood pressure goal and only 5.5% simultaneously at systolic and diastolic goal. By the end of the observational period the percentage of patients reached optimal BP goal values increased to 51.6%, 54.1% and 33.0%, respectively (systolic, diastolic, systolic and diastolic). Also the proportion of those who achieved primary target BP below 140/90 mmHg was higher. At baseline 19.2% of patients had BP below 140/90 mmHg, which increased to 87.1% by the end of the study. Patients tolerated SPC telmisartan/amlodipine well, 95% of the patients continued to receive prescribed medication after study conclusion. Conclusion: These real world data shows that the introduction of a fix dose combination therapy after free combination therapy increases the success rate of treatment during a relative short period, however many of the patients would still need higher doses or additional therapy after 3 months in order to achieve the optimal BP target levels. ]

[Chronic obstructive pulmonary disease is a very common comorbidity of hypertension and it is often unrecognised by physicians. The factors involved in the pathomechanism of both diseases should be realised when choosing treatment. Among factors, hypoxia, increased tone of sympathetic nervous system and activation of renin-angiotensin-aldosterone system should primarily be considered. Vascular wall damage and endothelial dysfunction has an important role in both conditions. The goals of treatment are elimination of risk factors, optimizing the blood pressure, the consequential prevention of cardio-cerebrovascular, renal and pulmonary damage; finally prolonging the patients’ life and improving their quality of life as well. Both hypertension and COPD significantly worsen the condition of COVID-19 patients since they increase the severity of the disease and the rate of in-patients’ and their mortality. In the treatment of hypertension among COPD and COVID-19 patients there must be emphasized the medication inhibiting of renin-angiotensin-aldosterone system, such as angiotensin-converting en­zyme inhibitors or angiotensin-II AT1 re­cep­tor antagonists. Special attention concerned the beneficial effect of mineralocorticoid receptor antagonist spironolactone. Other antihypertensive drugs (calcium channel blockers, thiazide-like diu­retics, high selectivity β1 receptor antagonists) may supplement the treatment if necessary. Long-acting β2 receptor agonists, muscarinic receptor antagonists and inhalation corticosteroids may be administered in double or triple combination also in hypertension and COPD as well. It is important to note, that statin therapy and also vitamin D3 improve the condition of COVID-19 patients.]