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Hypertension: history and development of established and novel treatments

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Abstract

Background

This article summarizes the emerging field of hypertension over the last decades. It covers paradigm shifts on hypertension from an undefined cardiovascular condition to the most relevant cardiovascular modifiable risk factor and the developments of drug treatments and interventional treatments to improve cardiovascular outcomes.

Methods

We performed a selective literature research in PubMed on trials published in the past until 2018 without time restrictions and covered unpublished trials disclosed in ClinicalTrials.org.

Results

The development of treatments of hypertension is a success story covering many decades from the early attempts with drug treatments, development of tolerable and effective medications to interventional techniques involving renal denervation, AV fistulas, and autonomic devices. Novel guidelines define new definitions and treatment targets of hypertension, which are a matter of ongoing discussion.

Conclusion

Despite the development of tolerable and effective drugs, new treatments in the field of neuroendocrine modulation by drugs and devices are still under development trying to further improve treatment of patients with hypertension and to further reduce cardiovascular events in those individuals.

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Fig. 1
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Fig. 6

Modified from Azizi et al. [87]

Fig. 7

Modified from Townsend et al. [92]

Fig. 8

Modified from Mahfoud F, presented at EuroPCR 2018

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  1. Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Universität des Saarlandes, Angiologie und Internistische Intensivmedizin, Kirrberger Str. 1, 66421, Homburg, Saar, Germany

    Milan Wolf, Sebastian Ewen, Felix Mahfoud & Michael Böhm

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  1. Milan Wolf
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Wolf, M., Ewen, S., Mahfoud, F. et al. Hypertension: history and development of established and novel treatments. Clin Res Cardiol 107 (Suppl 2), 16–29 (2018). https://doi.org/10.1007/s00392-018-1299-y

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