Best antihypertensive strategies to improve blood pressure control in Latin America: Position of the Latin American Society of Hypertension

Antonio Coca, Patricio López-Jaramillo, Costas Thomopoulos, Alberto Zanchetti

Research output: Contribution to journalArticlepeer-review

Abstract

Evidence from randomized trials has shown that effective treatment with blood pressure (BP)-lowering medications reduces the risk of cardiovascular morbidity and mortality in patients with hypertension. Therefore, hypertension control and prevention of subsequent morbidity and mortality should be achievable for all patients worldwide. However, many people in Latin America remain undiagnosed, untreated or have inadequately controlled BP, even where this is access to health systems. Barriers to hypertension control in low-income countries include difficulties in transportation to health services; inappropriate opening hours; difficulties in making clinic appointments; inaccessible healthcare facilities, lack of insurance and high treatment costs. After a review of the best recent available evidence on the efficacy and tolerability of antihypertensive drugs and strategies, the Latin American Society of Hypertension experts conclude that all major classes of BP-lowering drugs be available to hypertensive patients, because all have been shown to reduce major cardiovascular outcomes compared with placebo, and have shown to be associated with a comparable risk of major cardiovascular events and mortality when compared between classes. Within each class, no evidence whatsoever is available to show that one compound is more effective than another in outcome prevention. Therefore, the selection of individual drugs may be based mainly on the capacity of Latin American governments to obtain the lowest prices of the different molecules manufactured by companies with high production quality standards.

Original languageEnglish
Pages (from-to)208-220
Number of pages13
JournalJournal of Hypertension
Volume36
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

Keywords

  • access to health systems
  • antihypertensive drugs
  • antihypertensive strategies in low-income countries
  • availability of antihypertensive drugs

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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