Most common mistakes in hypertension management

Arterial hypertension is one of the most prevalent diseases in the Czech population, but unfortunately, its control does not reach satisfactory levels. It is therefore clear that there is still potential for improvement in its management. This article lists the most common problems, points out the possible consequences of these mistakes, and suggests the correct approach to solving them. In terms of diagnosis, we make errors not only in clinic blood pressure measurement but also in the use of out-of-office blood pressure measurement. Another shortcoming is the insufficient use of supplementary tests, which are mandatory for all hypertensive patients. In the context of hypertension treatment, this is primarily the failure to use fixed drug combinations at the initiation of treatment. Furthermore, there is medical inertia associated with insufficient treatment escalation and early treatment modification if the patient experiences adverse effects. In cases of severe hypertension, it is the failure to use mineralocorticoid receptor blockers as the fourth-line drug and the failure to use diuretics when the patient needs three or more antihypertensive drugs. Finally, there is insufficient monitoring of adherence to treatment.

Keywords: arterial hypertension, management errors in hypertension, diagnostic of hypertension, therapy of hypertension.