2. The Importance of Hypertension…
 Hypertension is a powerful risk factor for cardiovascular morbidity
and mortality, including:
 Ischemic heart disease
 Ischemic and hemorrhagic stroke
 Heart failure
 Chronic kidney disease, and
 Cognitive decline.
 Hypertension is also a potentially preventable cause of premature
morbidity and mortality.

3. Hypertension contributes significantly to
the global burden of disease and global mortality
16 million
7–8 million
4–3 million
2–3 million
Global mortality
128 million
59 million
39 million
30 million
Global burden of disease
All cardiovascular
High BP
High cholesterol
Overweight and obesity
Ezzati et al. PloS Med 2005;2:e133
According to the 2010 data from the Institute for Health Metrics
and Evaluation, hypertension is the biggest contributor to the
global burden of disease (GBD) and to global mortality

4. Hypertensive Patients Are at Increased Risk for
Cardiovascular Events
Framingham Heart Study - Risk of Cardiovascular Events by Hypertensive Status
in Patients Aged 35-64 Years; 36-Year Follow-Up
Kannel WB JAMA 1996;275(24):1571-1576.
Risk Ratio 2.0 2.2 3.8 2.6 2.0 3.7 4.0 3.0
Excess Risk 22.7 11.8 9.1 3.8 4.9 5.3 10.4 4.2
BiennialAge-AdjustedRateper
1000
0
10
20
30
40
50
Coronary Disease
9.5
45.4
21.322.7
Men Women
Peripheral Artery
Disease
5
2
9.9
7.3
Men Women
Cardiac Failure
3.5 2.1
13.9
6.3
Men Women
Stroke
3.3 2.4
12.4
6.2
Men Women
Normotensive
Hypertensive

5. Managing the Patient with Hypertension...
How do I control my
Blood Pressure?
What should my
Blood Pressure be?
What should my
Patient’s Blood Pressure
Target be?
What therapeutic
intervention should I
advise to achieve this?
Is my Blood Pressure
too high?
At what Blood Pressure
should I consider
treating my patient?

6. At what Blood Pressure should treatment be started?
What is the Target Blood Pressure
(for the patient under consideration)?
Which Drug should I prescribe to get to that target?
3 Important Clinical Questions to Answer...

7. An Overview of Hypertension Guidelines

8. Guidelines… Why do we need them?
 Guidelines provide a useful and practical framework with which medical
practitioners can deliver optimal healthcare for their patients.
 Guidelines give physicians and healthcare providers assurance that their
treatment is aligned with that of fellow professionals from other
countries, both regionally and internationally.
 Guidelines provide patients with the confidence and assurance that their
medical practitioners are up-to-date with current therapies and treatment
regimes that conform to an internationally accepted standard and quality
of care.
 Guidelines are now published based on extensive clinical trial evidence
in millions of diverse patient populations worldwide.

10. Blood Pressure Goals of New Hypertension Guidelines
Guidelines Population BP target Recommended drugs
BHS/NICE (2011) General <80 <140/<90 ARB/ACE-I for <55
General >80 <150/<90 CCB for >55 or AA-Blacks
KDIGO (2012) CKD no/mild proteinuria <140/<90 No specific recommendation
CKD +proteinuria <130/<80 ARB or ACE-I
ESH/ESC (2013) General non-elderly <140/<90 All
General elderly <80 140-150/<90 All
(<140 if tolerated)
General elderly >80 140-150/<90 All
Diabetics <140/<85 All, but RAS blockers
preferred if proteinuria present
CKD <140/<90 RAS blockers preferred, no Aldo
CKD with proteinuria <130/<90 RAS blockers preferred, no Aldo

12. Risk Stratification
No other RF
Blood pressure (mm Hg)
The 2013 ESH/ESC Guidelines for the
Management of Arterial Hypertension
High normal Grade 1 HT Grade 2 HT Grade 3 HT
SBP 130-139 SBP 140-159 SBP 160-179 SBP >180
or DBP 85-89 or DBP 90-99 or DBP 100-109 or DBP >110
Other risk factors,
asymptomatic organ damage
or disease
1-2 RF
>3 RF
OD, CKD stage 3 or diabetes
Low risk Moderate risk High risk
Low risk Moderate risk
Low to
moderate risk
Moderate to
high risk
High risk
High risk
Symtomatic CVD, CKD stage
>4 or diabetes with OD/RFs
Moderate to
high risk
Moderate to
high risk
High risk
High risk High risk
High to
very high risk
Very high riskVery high risk Very high risk Very high risk

13. Risk Stratification
No other RF
Blood pressure (mm Hg)
The 2013 ESH/ESC Guidelines for the
Management of Arterial Hypertension
High normal Grade 1 HT Grade 2 HT Grade 3 HT
SBP 130-139 SBP 140-159 SBP 160-179 SBP >180
or DBP 85-89 or DBP 90-99 or DBP 100-109 or DBP >110
Other risk factors,
asymptomatic organ damage
or disease
1-2 RF
>3 RF
OD, CKD stage 3 or diabetes
Low risk Moderate risk High risk
Low risk Moderate risk
Low to
moderate risk
Moderate to
high risk
High risk
High risk
Symtomatic CVD, CKD stage
>4 or diabetes with OD/RFs
Moderate to
high risk
Moderate to
high risk
High risk
High risk High risk
High to
very high risk
Very high riskVery high risk Very high risk Very high risk

14. To Summarize: Your patients’ BP target...
 If your patient has diabetes:
 Aim for a SBP target of <140 mm Hg (ESH/ESC, JNC 8, ASH,
ADA)
 Aim for a DBP target of 80-90 mm Hg (ESH/ESC, JNC 8, ASH)
 The ADA and CHEP recommend a DBP target of < 80 mm Hg
 If your patient has CKD:
 Aim for a BP target of <140/<90 mm Hg (All)
 If your patient has proteinuria (CKD and/or diabetes):
 Aim for a SBP target of <130 mm Hg (KDIGO, ESH/ESC, ASH)
 Aim for a DBP target of <80 mm Hg (KDIGO, ASH) (<90 mm
Hg for ESH/ESC)

15. To Summarize: Your patients’ BP target...
 For your patient without diabetes, CKD or proteinuria:
 Aim for a BP target of <140/<90 mm Hg (All guidelines)
 When your patient reaches the age of 80:
 Continue to maintain the BP target of <140/<90 mm Hg if
tolerated (ESH/ESC), OR
 Aim for a higher SBP target of <150 mm Hg (BHS/NICE, ASH,
CHEP)
(JNC 8 suggests a target of <150/<90 mm for patients >60)

16. Anti-Hypertensive Therapy

17. Initiation of Lifestyle Changes and Antihypertensive drug treatment
No other RF
Blood pressure (mm Hg)
The 2013 ESH-ESC Guidelines for the
Management of Arterial Hypertension
High normal Grade 1 HT Grade 2 HT Grade 3 HT
SBP 130-139 SBP 140-159 SBP 160-179 SBP >180
or DBP 85-89 or DBP 90-99 or DBP 100-109 or DBP >110
Other risk factors,
asymptomatic organ damage
or disease
1-2 RF
>3 RF
OD, CKD stage 3 or diabetes
No BP intervention
• Lifestyle changes
for several months
• Add BP drugs
targeting <140/<90
• Lifestyle changes for
several weeks
• Then add BP drugs
targeting <140/<90
• Lifestyle changes
• Immediate BP drugs
targeting <140/<90
• Lifestyle changes
• No BP intervention
• Lifestyle changes for
several weeks
• Then add BP drugs
targeting <140/<90
• Lifestyle changes
• No BP intervention
• Lifestyle changes for
several weeks
• Then add BP drugs
targeting <140/<90
• Lifestyle changes
• Immediate BP drugs
targeting <140/<90
• Lifestyle changes
• Immediate BP drugs
targeting <140/<90
Symptomatic CVD, CKD stage
>4 or diabetes with OD/RFs
• Lifestyle changes for
several weeks
• Then add BP drugs
targeting <140/<90
• Lifestyle changes
• No BP intervention
• Lifestyle changes
• BP drugs
targeting <140/<90
• Lifestyle changes
• BP drugs
targeting <140/<90
• Lifestyle changes
• BP drugs
targeting <140/<90
• Lifestyle changes
• Immediate BP drugs
targeting <140/<90
• Lifestyle changes
• Immediate BP drugs
targeting <140/<90
• Lifestyle changes
• No BP intervention
• Lifestyle changes
• BP drugs
targeting <140/<90
• Lifestyle changes
• BP drugs
targeting <140/<90

18. Choice of Anti-hypertensive Therapy
 The current ESH/ESC guidelines confirm that diuretics, beta-blockers,
calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors
and angiotensin receptor blockers are all suitable for the initiation and
maintenance of antihypertensive treatment, either as monotherapy or in
some combinations.
 In the general nonblack population, including those with diabetes, initial
antihypertensive treatment should include a thiazide-type diuretic,
calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor
(ACEI), or angiotensin receptor blocker (ARB). (JNC 8)
 The American Society of Hypertension (ASH), Canadian Hypertension
Education Program (CHEP) and the National Institute for Health and
Clinical Excellence (NICE) guidelines recommend initial therapy based
on age and ethnicity.
All guidelines agree that the choice of drugs to be considered would
depend on whether there are any compelling indications that would
necessitate the preferential use of a group of drugs over another.

19. To Summarize: Your Choice of Anti-hypertensive Drug...
 If your patient has diabetes:
 ARB and ACE-I recommended, especially if there is proteinuria (ASH/ISH)
 Regimen should include a RAS blocker (ADA)
 All groups of drugs but RAS blockers preferred if proteinuria is present
(ESH-ESC)
 All groups of drugs (JNC 8, CHEP)
 If your patient has CKD:
 ARB or ACE-I recommended (ASH/ISH, JNC 8)
 RAS blockers preferred, no Aldosterone (ESH-ESC)
 ARB or ACE-I in CKD with proteinuria, no specific recommendation in CKD
without proteinuria (KDIGO)

20. To Summarize: Your Choice of Anti-hypertensive Drug...
 For your general hypertensive patient:
 All groups of drugs (ESH-ESC)
 All groups of drugs in the non-black population (JNC 8)
 ARB or ACE-I in “younger” non-black patients (<55 in BHS/NICE,
<60 in ASH/ISH)
 CCB or Diuretic in “older” non-black patients (>60 in ASH/ISH)
 CCB in “older” non-black patients (>55 in BHS/NICE)
 For your “high-risk” patient (CHEP):
 ARB or ACE-I

21. Multiple antihypertensive agents are required to reach
BP goal, particularly in patients with co-morbidities
Average no. of antihypertensive medications
1 2 3 4
Trial (SBP achieved)
ALLHAT (138 mmHg)
RENAAL (141 mmHg)
UKPDS (144 mmHg)
ABCD (132 mmHg)
MDRD (132 mmHg)
HOT (138 mmHg)
AASK (128 mmHg)
ACCOMPLISH (132 mmHg)
Initial 2-drug combination therapy
Bakris et al. Am J Med 2004;116(5A):30S–8; Dahlöf et al. Lancet 2005;366:895–906
Jamerson et al. Blood Press 2007;16:80-6; Jamerson et al. N Engl J Med 2008;359:2417-28
IDNT (138 mmHg)
ASCOT-BPLA (136.9 mmHg)
~1/3 normalized with 1 drug
~1/3 normalized with 2 drugs
~1/3 normalized with >3 drugs

22. Rationale for Combination Therapy
 Combines drugs acting on different physiological systems in a situation
where the phenotype is not known and where a pharmacological
‘attack’ on two (or more) systems will have a greater impact on blood
pressure reduction than blind monotherapy.
 Blocks counter-regulatory responses that are activated by the
perturbation of the blood pressure regulatory mechanisms when a
physiological system is blocked with single-drug therapy.
 Reduces blood pressure variability.
 More and more patients, particularly the elderly and those with multiple
risk factors, require two or more drugs for adequate blood pressure
control.
Modified from Sever PS, Messerli F. Eur Heart J, (2011) 32 (20): 2499-2506

23. Guidelines Recommendations on Combination Therapy
 Initiation of antihypertensive therapy with a two-drug combination may be
considered in patients with markedly high baseline BP or at high CV risk.1
 The guidelines favour the use of combinations of two antihypertensive
drugs at fixed doses in a single tablet, because reducing the number of
pills to be taken daily improves adherence... and increases the rate of BP
control.1
 In no less than 15–20% of hypertensive patients, BP control cannot be
achieved by a two-drug combination. When three drugs are required, the
most rational combination appears to be a blocker of the renin–
angiotensin system, a calcium antagonist & a diuretic at effective doses.2
1Mancia G, et al. Journal of Hypertension 2013, 31:1281–1357.
2Mancia G, Laurent S, Agabiti–Rosei E et al. Journal of Hypertension 2009, 27:2121–2158

26. Treatment of Adults with Systolic/Diastolic Hypertension
without Other Compelling Indications
TARGET <140/90 mmHg
INITIAL TREATMENT AND MONOTHERAPY
• BBs are not indicated as first line therapy for age 60 and above
Beta-
blocker*
Long-acting
CCB
Thiazide ACEI" ARB"
Lifestyle modification
therapy
ACEI, ARB and direct renin inhibitors are contraindicated in pregnancy and caution is
required in prescribing to women of child bearing potential
A combination of 2 first line drugs may be considered as initial therapy if the blood
pressure is >20 mmHg systolic or >10 mmHg diastolic above target

27. 2013 ESH-ESC Guidelines for Arterial Hypertension:
Choice of antihypertensive drugs
Angiotensin-
receptor blockers
Calcium
antagonists
ACE inhibitors
Other
antihypertensives
Beta-blockers
Thiazide diuretics

28. Preferred 2-drug
combinations
Acceptable 2-drug
combinations
Unacceptable 2-drug
combinations
• ACE inhibitor/diuretic
• ARB/diuretic
• ACE inhibitor/CCB
• ARB/CCB
• Beta-blocker/diuretic*
• CCB/diuretic
• Renin inhibitor/diuretic
• Thiazide diuretic/potassium-
sparing diuretic
• ACE inhibitor/ARB
• ACE inhibitor/beta blocker
• ARB/beta blocker
• CCB (non-dihydropyridine)/
beta blocker
• Centrally acting agent/beta
blocker
Sever PS, Messerli F. Eur Heart J, (2011) 32 (20): 2499-2506
• Beta-blocker/diuretic
• CCB/diuretic
• CCB (di-hydropyridine)/
beta blocker
• Renin inhibitor/diuretic
• Renin inhibitor/CCB
• Dihydropyridine CCB/non-
dihydropyridine CCB
• ACE inhibitor/ARB
• Renin inhibitor/ARB
• Renin inhibitor/ACE inhibitor
• RAS inhibitor/beta blocker
• CCB (non-dihydropyridine)/
beta blocker
• Centrally acting agent/beta
blocker
CCB=calcium-channel blocker
ARB=angiotensin-receptor blocker
Hypertension management 2011:
optimal combination therapy

29. Preferred 2-drug
combinations
Acceptable 2-drug
combinations
Unacceptable 2-drug
combinations
• ACE inhibitor/diuretic*
• ARB/diuretic*
• ACE inhibitor/CCB*
• ARB/CCB*
• Beta-blocker/diuretic*
• CCB/diuretic
• Renin inhibitor/diuretic
• Thiazide diuretic/potassium-
sparing diuretic
• ACE inhibitor/ARB
• ACE inhibitor/beta blocker
• ARB/beta blocker
• CCB (non-dihydropyridine)/
beta blocker
• Centrally acting agent/beta
blocker
*Single-pill combinations available in the US
CCB=calcium-channel blocker
ARB=angiotensin-receptor blocker
Gradman AH et al. J Am Soc Hypertens 2010, 4:42-50., 90-98.
Drug combinations in hypertension:
Recommendations of ASH

30. Australian Heart Foundation: Combination Therapy
ACE inhibitor or
Angiotensin II receptor
antagonist
plus Calcium channel blocker
Based on the best available evidence, the most effective combination is:
Other effective combinations include:
ACE inhibitor or
Angiotensin II receptor
antagonist
plus Thiazide diuretic
ACE inhibitor or
Angiotensin II receptor
antagonist
plus Beta-blocker
Beta-blocker
plus
plus
plus
Di-hydropyridine
calcium channel blocker
Thiazide diuretic Calcium channel blocker
Thiazide diuretic Beta-blocker (not recommended in people with glucose intolerance,
metabolic syndrome or established diabetes)
(particular role in the presence
of coronary heart disease)
(recommended post myocardial
infarction or in people with heart
failure)
(particular role in the presence
of heart failure or post stroke)
(particular role in the presence of
diabetes or lipid abnormalities)

31. Properties of Telmisartan compared to other ARBs
Telmisartan Losartan Irbesartan
Candesartan
Cilexetil
Olmesartan
medoxomil Eprosartan Valsartan
Active metabolite No EXP3174 No Candesartan Olmesartan No No
Bioavailability (%) 30–60 29–43 60–80 15–42 26–29 13–15 10–43
Volume of
distribution (L)
500 28–47 53–93 9 17 13 17
Terminal t½ (h) 24 6–9 11–15 3–11 10–15 5–7 9
Hepatic: renal
elimination
98:2
no CYP450
65:35
CYP450
80:20
CYP450
67:33
no CYP450
60:40
no CYP450
90:10
no CYP450
80:20
no CYP450
Protein binding
(%)
99.5 98.7 90.0 99.5 99.0 98.0 95.0
t½= elimination half-life;
Table adapted from: Brunner HR. J Hum Hypertens 2002;16(Suppl. 2):S13–6. Burnier M, Brunner HR. Lancet
2000;355:637–45; Barreras A, Gurk-Turner C. BUMC Proceedings 2003; 16:123–6; Israili ZH. J Hum Hypertens
2000;14(Suppl. 1):S73–S86. Whittaker A. Br J Cardiol 2005;12:125–9
Compared to other ARBs, telmisartan has a
high oral bioavailability and a longer half-life

32. Amlodipine has Shown CV Protective Efficacy
in Landmark Studies
1. Pitt et al. Circulation. 2000;102:1503–1510; 2. Nissen et al. JAMA. 2004;292:2217–2226; 3. Dahlof et al. Lancet.
2005;366:895–906; 4. Williams et al. Circulation. 2006;113:1213 –1225; 5. Leenen et al. Hypertension.2006;48:374–384.
PREVENT1
825 CAD patients (≥ 30%); multicentre,
randomized, placebo-controlled
Primary outcome: no difference in mean 3-y coronary
angiographic changes vs placebo
35% ↓hospitalization for heart failure + angina
33% ↓revascularization procedures
CAMELOT2
1,991 CAD patients (≥ 20%); double-blind,
randomized study vs placebo and enalapril 20 mg
Primary outcome: 30%↓in CV events vs placebo
41% ↓hospitalization for angina
27% ↓coronary revascularization
ASCOT-BPLA/CAFE3,4
19,257 HTN patients; multicentre, randomized,
prospective study vs atenolol
Primary outcome: 10%↓in non-fatal MI and fatal CHD
16% ↓total CV events and procedures
30% ↓new-onset diabetes
27% ↓stroke
11% ↓all-cause mortality
4.3 mmHg ↓central aortic pressure
ALLHAT5
18,102 HTN patients; multicentre, randomized,
prospective study vs lisinopril
Primary outcome: no difference in composite of fatal CHD and
non-fatal MI vs lisinopril
6% ↓combined CVD
23% ↓stroke

33. 33
Telmisartan is the Most Studied Amongst ARBs in Mortality
and Morbidity Endpoint Trials
Numberofpatients
44,264
51,878
19,335
12,565
1,405
1. Schrader et al. Stroke. 2005;36:1218–1226; 2. http://www.roadmapstudy.org/resident.aspx; 3. Parving et al. N Engl J Med. 2001;345:870–878; 4. Lewis et al. N Engl
J Med. 2001;345:851–860; 5. Carson et al. J Card Fail. 2005;11:576–585; 6. Papademetriou et al. J Am Coll Cardiol. 2004;44:1175–1180; 7. www.atacand.com; 8.
Brenner et al. N Engl J Med. 2001;345:861–869; 9. Pitt et al. Lancet. 2000;355:1582–1587; 10. Dickstein et al. Lancet. 2002;360:752–760; 11. Dahlof et al. Lancet.
2002;359:955–1003; 12. Cohn et al. N Engl J Med. 2001;345:1667–1675; 13. www.novartis.com; 14. Pfeffer et al. N Engl J Med. 2003;349:1893–1906; 15. Julius et al.
Lancet. 2004;363:2022–2031; 15. www.ontarget-micardis.com.
6,405
4,449
Val-HeFT
12
IRMA II3
LIFE11
ONTARGET®16
TRANSCEND®16
PRoFESS®16NAVIGATOR
13
VALIANT
14
VALUE
15
OPTIMAAL10
ELITE II9
RENAAL8SCOPE
6
CHARM
7
MOSES1
IDNT4
I-Preserve
5
ROADMAP2
Epro-
sartan
Lo-
sartan
Val-
sartan
Cande-
sartan
Irbe-
sartan
Telmi-
sartan
Olme-sartan

34. * A5 and T80/A5 for the first 2 weeks, then forced-titration to A10 and T80/A10, respectively;
baseline BP = 185.4/103.2 mmHg
Meanchangefrombaseline(mmHg)
A5–A10* (n = 195)
-5
-10
-15
-20
Week
p =
0.0301
p =
0.0089
p =
0.0001 p =
0.0002
p =
0.0006
0 2 4 6 8
DBP
T80/A5–A10* (n = 379)
Meanchangefrombaseline(mmHg)
-10
-20
-30
-40
-50
0 2 4 6 8
Week
p =
0.0077
p =
0.0001
p =
0.0001 p =
0.0001
p =
0.0002
SBP
Telmisartan/Amlodipine Provides Significant BP Reductions
(> 31 mmHg SBP) After Only 1 Week of Treatment
Neutel et al. J Clin Hypertens. 2010: In press; ASH 2010 poster presentation (LB-PO-10).

35. Telmisartan Plus Amlodipine (80/10) Provides Consistent
BP Reductions Across HTN Severities
-33.7
-36.9
-47.5 -48.9
-60
-50
-40
-30
-20
-10
0
160 – < 1701 190 – < 2002
170 – < 1801 180 – < 1902
1. Littlejohn et al. J Clin Hypertens. 2009;11:207–213; 2. Neutel et al. J Clin Hypertens. 2010;
ASH 2010 poster presentation (LB-PO-10) & data on file
Moderate HTN Severe HTN
Baseline SBP =
(n = 31) (n = 71)(n = 13) (n = 305)
MeanSBPreductionsfrom
baseline(mmHg)

36. Obese
BMI ≥ 301
(n = 175)
-43.2
-60
-50
-40
-30
-20
-10
0
Diabetic1
(n = 62)
Metabolic
syndrome1*
(n = 36)
Severe HTN
≥ 180/95 mmHg2
(n = 379)(n = 100)
Elderly
≥ 65 y1
(n = 30)
Black1
MeanSBPreductionsfrom
baseline(mmHg)
Mean baseline BP = 185.4/103.2 mmHg
* Diabetes, obesity (BMI ≥ 30kg/m2), and HTN
1. TEAMSTA Severe HTN study (data on file; Boehringer Ingelheim Pharmaceuticals, Inc);
2. Neutel et al. J Clin Hypertens. 2010: In press; ASH 2010 poster presentation (LB-PO-10).
Telmisartan Plus Amlodipine Provides Consistently High BP
Reductions in Hypertensive at-Risk Patients
-46.8 -46.6 -46.1 -47.5
-44.2

37. Telmisartan (mg)
0
5
10
15
20
25
04080
0
5
10
Telmisartan (mg)
0
2
4
6
8
10
12
14
16
04080
0
5
10
24-h mean SBP reduction
(mmHg)
24-h mean DBP reduction
(mmHg)
** p < 0.001; *** p < 0.0001 vs Telmisartan alone; ††† p < 0.0001 vs Amlodipine alone; n = 562
***†††
***†††
***†††
***†††
***†††
**†††
***†††
***†††
Telmisartan Plus Amlodipine Provides Consistent 24-h ABPM
Dose Response
Littlejohn et al. J Hypertens. 2008;26(suppl 1):S494; White et al. Blood Press Monit. 2010.

38. Conclusions
 Hypertension remains a powerful and important risk factor for cardiovascular
disease.
 As we review the various available guidelines, it is essential that we
determine how they may be applicable to our daily clinical practice.
 In managing our patients with hypertension, we need to:
 Assess their overall cardiovascular risk
 Determine the patient’s appropriate blood pressure
 Advise non-pharmacological lifestyle measures
 Select an appropriate anti-hypertensive agent/agents
 The ARB/CCB combination of Telmisartan and Amlodipine has been shown
to provide excellent blood pressure control in a range of hypertension
severities and in a variety of difficult-to-treat and high-risk hypertensives.

39. Thank you!

40. Striving towards a blood pressure goal...
 Categorization of blood pressure
 Risk stratification of hypertensive patients
 Decision on target blood pressure
 Choice of treatment