Practical Case Studies in Hypertension Management – serie

This book guides readers through the correct use and consequent diagnostic and therapeutic relevance of 24-h ambulatory blood pressure monitoring (ABPM) in a wide spectrum of clinical presentations and different phenotypes of arterial hypertension. On the basis of eight case studies, the author reviews and discusses current guidelines and recommendations aimed at optimizing the diagnostic and therapeutic approach in commonly encountered real-world clinical scenarios, including challenging cases of white-coat hypertension, masked hypertension, isolated nocturnal or diurnal hypertension, hypertension and obstructive sleep apnea, pseudo-resistant and true-resistant hypertension, and drug-induced hypotension. This handy and practical book provides physicians in the area of general and internal medicine, as well as specialists in cardiovascular risk, valuable insights for optimizing the treatment of these hypertensive patients.

This book is designed to assist physicians in choosing among diagnostic procedures and therapeutic options when caring for patients with hypertension and markers of organ damage. The comprehensive description of practical clinical cases sets this book apart from other publications and will help the reader to transfer general guideline recommendations to the clinical setting. With this purpose, the cases have been selected to reflect situations frequently encountered during clinical routine, rather than hypertensive crises or emergencies or the rare presentations that tend to be addressed in case reports in scientific journals. The scenarios considered include treated hypertension with uncontrolled blood pressure levels in patients with left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis, microalbuminuria and renal impairment, proteinuria and renal disease, and abnormal pulse pressure. By representing clinical practice in a “real world” setting, these paradigmatic cases will enable the practitioner to select the diagnostic tools and form of treatment best suited to the individual patient and the particular cardiovascular risk profile, thereby optimizing outcomes.

This book is designed to assist physicians in the everyday management of hypertensive patients, with a particular focus on difficult-to-treat and resistant hypertension. The selected clinical cases are representative of the patients who are seen in the “real world”, rather than rare clinical cases, and provide examples of management according to current international guidelines. The scenarios considered include not only cases in which arterial hypertension is truly resistant but also instances of pseudo-resistant hypertension, including cases in which resistance is related to comorbidities, concomitant treatments, or the use of drugs. The ultimate objective is to provide paradigmatic examples of evidence-based approaches to difficult-to-treat patients that will help physicians to select the most appropriate diagnostic tools and evidence-based treatment strategy for each individual patient.

This guide is structured to assist physicians in the management of those hypertensive patients who present with specific comorbidities, such as diabetes, systolic dysfunction, obesity, renal disease, or previous cardiac events, often associated with hypertension. The clinical cases contained in this book have been selected to provide a paradigmatic set of scenarios frequently encountered in daily clinical practice, and will serve as an easy-to-access tool in applying general guidelines to individual patients, particularly in the choice of the most appropriate antihypertensive therapy. Treatment of hypertension with associated clinical conditions require specific therapies and combinations of drugs, which are necessarily different from one comorbidity to another. By discussing exemplary cases that may better represent clinical practice in a “real world” setting, and analyzing step by step the diagnostic and therapeutic process, this book will assist cardiologists and physicians in selecting the diagnostic tools and forms of treatment best suited to the individual patient and the particular cardiovascular risk profile.

The aim of this guide is to provide clinicians with practical reference for the management of hypertensive patients with other cardiovascular risk factors, which originate from impaired metabolic functions. With the aid of carefully selected, paradigmatic case studies, the physician will find sound advice for the best approach to common but often under-recognized clinical situations, and answers to practical questions that arise when a specific condition is not directly addressed in the guidelines. Question-and-answer sections will help the reader to identify at a glance the most complex steps in the diagnostic and therapeutic process. In a “real world” clinical setting, the hypertensive patient rarely presents with hypertension as the only cardiovascular risk factor, and is more likely to be affected by other metabolic risk factors, such as impairment of lipid metabolism, glucose homeostasis, and purine metabolism, and by overweight or obesity. These cases will serve as abasis for analyzing best practice, highlighting problems in diagnosis and treatment, and selecting the most appropriate management of patients with metabolic risk factors in everyday practice.

This book identifies the key determinants in the management of hypertensive outpatients with Cardiac Target Organ Damage. It sheds light on current international guidelines by directly applying them to six representative clinical cases that reflect situations frequently encountered during clinical routine rather than emergencies or rare occurrences.The book enables cardiologists and angiologists alike to gain an overview of the most frequent cardiac dysfunctions related to hypertension: left atrial enlargement, aortic root dilatation, diastolic dysfunction, systolic dysfunction, left and right ventricular enlargement. Each case is illustrated and analyzed in detail – from family and personal history to treatment and follow-up – providing readers with valuable guidance that will help them to select the best suited diagnostic tool and treatment for each patient.