Personalized strategy for blood pressure control in patients with arterial hypertension
DOI:
https://doi.org/10.32782/2415-8127.2026.73.8Keywords:
arterial hypertension, choice of antihypertensive therapy, thiazide /thiazide-like diuretics, indapamide, chronotherapyAbstract
Introduction. Arterial hypertension is one of the most common chronic diseases of the cardiovascular system and a significant risk factor for the development of severe cardiovascular complications. Therefore, it has considerable medical and social significance.
Aim of the study. To draw specialists’ attention to the importance of an individualized approach to the treatment of patients with arterial hypertension.
Materials and methods. Analysis of a clinical case.
Results. The presented clinical case demonstrates the difficulties in achieving stable blood pressure (BP) control in a female patient with stage III essential hypertension and a very high cardiovascular risk. Adjustment of therapy, namely replacing hydrochlorothiazide with indapamide as a long-acting drug, is pathogenetically justified and consistent with current ESH/ESC recommendations, especially in cases of resistant or poorly controlled arterial hypertension. This change, together with shifting the intake of a calcium channel blocker to the evening, made it possible to achieve more stable BP control and improve treatment tolerability without adding an additional antihypertensive agent. BP variability and the morning BP surge should be considered additional therapeutic targets in the management of high-risk hypertensive patients, as their correction may be crucial for the prevention of stroke and other cardiovascular complications. In clinical studies, indapamide has demonstrated advantages not only in providing a more pronounced and stable BP reduction, but also in terms of organ protection, particularly the potential regression of left ventricular hypertrophy.
Conclusions. Analysis of the presented clinical case confirms the appropriateness of an individualized approach to selecting optimal antihypertensive therapy, taking into account patient-specific characteristics, to achieve effective and stable blood pressure control. Available evidence from clinical studies indicates additional antihypertensive and organ-protective efficacy of indapamide.
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