White coat hypertension, nocturnal dipping, nocturnal hypertension, and increased BP variability are more common in high-risk patients than in low-risk patients with high BP; these conditions are best characterized using ABPM, allowing improved management of patients already at increased risk of CV events . Overall, the value of ABPM and HBPM for the diagnosis and monitoring of hypertension needs to be more widely understood and utilized, and clear strategies and
BP targets established for these methods. 5 Conclusions The 2013 ESH/ESC hypertension management guidelines recommend a more unified BP target for most patients, owing to a lack of compelling RCT evidence for the previously more aggressive
BP targets in high-risk patients. However, substantial evidence suggests that further CV benefits are available from more HMPL-504 research buy Selleck BYL719 intensive BP lowering and, until more solid RCT data are available, individualized treatment of high-risk patients may be prudent. Individual patient demographics, BP level, CV risk, co-morbidities, and preference should influence the chosen treatment strategy. An optimal therapy regimen that lowers BP and CV risk while being tolerable will encourage patient adherence. CCBs appear to be a favorable choice for monotherapy and in combination (with other antihypertensive agent classes) in many patients, and may provide specific beyond-BP-lowering benefits. The importance of ABPM and HBPM for comprehensive diagnosis of hypertensive conditions, patient risk stratification, and appropriate
treatment selection should be more widely acknowledged and utilized. These methods are likely to play an increasing role in the hypertension field. Acknowledgments Writing support in the preparation Progesterone of this manuscript was provided by PAREXEL International, and this support was funded by Bayer HealthCare. All authors contributed to the concept of the manuscript, critically reviewed the draft, and approved the final version. Conflict of interest Sverre Kjeldsen has received grant funding from AstraZeneca and Pronova; honorarium and consultancy fees from Bayer HealthCare, Serodūs Pharmaceuticals, Takeda, and Medtronic; lectureship fees from AstraZeneca, Bayer HealthCare, Medtronic, Merck Sharp & Dohme, Novartis, and Takeda; and royalties from Gyldendal. Tonje Aksnes has received lecture honorarium and travel support from AstraZeneca, Merck Sharp & Dohme, Novartis, and Pfizer. Luis Ruilope has received honorarium and consultancy fees from Bayer HealthCare. Open AccessThis article is distributed under the terms of the Creative Commons Attribution Noncommercial License which MK-0457 solubility dmso permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. References 1. Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G, et al.