A rational approach to the treatment of arterial hypertension in patients with high cardiovascular risk and metabolic disorders

Metabolic disorders are important in the development of cardiovascular diseases. Experts predict their frequency is steadily rising, which is a serious medical and social problem in modern society. Arterial hypertension (AH) is the most common risk factor in patients with metabolic disorders. In the selection of antihypertensive therapy it is necessary to consider not only the anti-hypertensive and organoprotective effects of drugs and their metabolic effects, which has prognostic value. Calcium antagonists, along with inhibitors of angiotensin converting enzyme (ACE) inhibitors and sartans have favorable metabolic effects. Lercanidipine related to the third generation dihydropyridine calcium antagonist, has been much more selective for the so-called slow calcium channels of vascular smooth muscle cells, which is associated with a good hypotensive, organo and metabolic action. Combination therapy with an ACE inhibitor and a calcium channel blocker, or angiotensin receptor blockers and calcium channel II is also a justified tactic for the management of patients with high-risk cardiovascular and metabolic disorders.