PHARMACOLOGICAL MANAGEMENT OF HYPERTENSION: ADAPTATION STRATEGIES AND SIDE EFFECTS

Abstract

The pharmacological management of systemic arterial hypertension aims primarily to control blood pressure and reduce the risk of cardiovascular, renal, and cerebral complications. Treatment is completely individualized, with choices based on patient characteristics, comorbidities, risk profile, and clinical response. Adaptation strategies include the selection of first-line medications, such as renin-angiotensin-aldosterone system inhibitors, calcium channel blockers, and thiazide diuretics, and the possibility of combining drugs when monotherapy is insufficient. National and international guidelines, such as the 79th Brazilian Guideline on Arterial Hypertension, guide this choice, and studies demonstrate that following these recommendations improves outcomes in primary care. Adaptation also considers factors such as age, race, and associated conditions, with tools such as recommendation matrices being developed to optimize clinical practice. Side effects are a relevant aspect, varying according to the therapeutic class: diuretics can cause electrolyte disturbances, ACE inhibitors are linked to dry cough, calcium channel blockers can lead to peripheral edema, and beta-blockers can cause fatigue and bradycardia. The rational combination of medications can minimize these events, reducing the need for high doses of each drug. Adherence to treatment is a critical challenge, directly impacted by the occurrence of side effects and the complexity of the therapeutic regimen. Therefore, successful management depends on continuous monitoring, patient education, and collaboration between healthcare professionals and individuals, ensuring a balance between therapeutic efficacy and safety.