Arterial hypertension – a leading cause of death.

Partly due to ageing, the rising incidence of obesity, and socio economic and environmental changes, its incidence increases worldwide. Hypertension commonly coexists with Type 2 diabetes, obesity, dyslipidaemia, sedentary lifestyle, and smoking leading to risk amplification. Blood pressure lowering by lifestyle modifications and anti hypertensive drugs reduce cardiovascular (CV) morbidity and mortality.

Guidelines recommend dual and triple combination therapies using renin-angiotensin system blockers, calcium channel blockers, and/or a diuretic. Comorbidities often complicate management. New drugs such as angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter

2 inhibitors, glucagon-like peptide-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists improve CV and renal outcomes. Catheter-based renal denervation may offer an alternative treatment option in comorbid hypertension associated with increased sympathetic nerve activity.

This review summarises the latest clinical evidence for managing hypertension with CV comorbidities.

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