Essential hypertension: a critical point of view.
Trials of antihypertensive therapy in mild hypertension find a reduction in cardiovascular events favoring active or drug intervention. A critical review of this evidence offers little justification for uniformly treating all of these patients. While the reduction in cardiovascular events is statistically significant, the absolute numerical reduction is much less impressive. Antihypertensive drug treatment does not appear to reduce complications of ischemic heart disease. Furthermore, drug therapy, while improving, causes a good deal of morbidity. Consequently, I advocate and have outlined a less aggressive approach to managing the asymptomatic patient with mild hypertension.
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects; D001581:Benzothiadiazines; D002986:Clinical Trials as Topic; D004232:Diuretics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects
D000959:Antihypertensive Agents; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors