Hypertension

In addition to diabetes, hypercholesterolemia and smoking, arterial hypertension is a major risk factor for the development of atherosclerosis. In addition to vessel occlusion due to atherosclerotic plaques, it can lead to complications, such as aneurysm formation. Every second person older than 50 years in the German population suffers from hypertension. This makes hypertension the most prevalent disease in internal medicine; however, only 40% of those affected receive sufficient treatment. Fatty streaks as a sign of early atherosclerosis can be found even in young people. A clinically relevant manifestation, however, is unusual before the age of 50 years. In patients with arterial hypertension and peripheral arterial occlusive disease (PAOD), renal artery stenosis should also be excluded. Lifestyle changes (e.g. cessation of smoking) are always necessary. As patients with hypertension and PAOD are always high-risk patients, antihypertensive drug treatment is always mandatory from the start. To achieve rapid treatment success and to enhance patient adherence, drug treatment should be started as a combination therapy preferably as a single pill in most patients. There is evidence that RAS inhibitors and calcium antagonists are particularly suitable medications for patients with hypertension and PAOD. A polypill containing antihypertensives, a statin and acetylsalicylic acid (ASS) in a single pill can improve the necessary adherence.