Impatto metabolico della terapia antiipertensiva nel paziente dislipidemico

Effective treatment of hypertension determines undoubted benefits in preventing cardiovascular events. All anti-hypertensive drugs available to date are potentially usable to start a monotherapy treatment, but in most cases a polytherapy is needed and it that can be made by combining drugs with a synergistic action. However, beyond the reduction of blood pressure, based on the mechanism of action and its side effects of each drug class, current guide lines recommend to choose the drug/drugs for a “personalized” anti-hypertensive treatment according to the patient’s global cardiovascular risk, the co-existence of other metabolic disorders and the presence or absence of organ damage. For example, in hypertensive patients with concomitant metabolic disorder (e.g. dyslipidemia), the use of drugs acting on RAAS, the alpha1 antagonists and the calcium channels blockers is recommended, whereas diuretics and beta blockers may have harmful side effects. The article summarizes the pros and cons of different antihypertensive drugs in terms of efficacy and tolerability and helps to do a rational choice for treatment in dyslipidemic patients.