INTRODUCTION: Systemic arterial hypertension is one of the strongest known modifiable risk factors for ischaemic heart disease, stroke, renal failure and heart failure. It remains poorly treated. As an asymptomatic disorder, people are understandably reluctant to accept adverse drug effects in addition to the inconvenience of long-term treatment. In this regard, modern drugs represent an enormous improvement. PATHOPHYSIOLOGY AND SITES OF DRUG ACTION Hypertension is occasionally secondary to some distinct disease. However, most patients with persistent arterial hypertension have essential hypertension. Arterial blood pressure is determined by cardiac output, peripheral vascular resistance and large artery compliance. Peripheral vascular resistance is determined by the diameter of resistance vessels (small muscular arteries and arterioles) in the various tissues. One or more of a ‘mosaic’ of interconnected predisposing factors (including positive family history, obesity and phys...
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