title: The evolution of antihypertensive therapy.
abstract: Beginning in the early 1950s, when a ganglioplegic agent and a vasodilator were used in combination to provide long-term control of severe hypertension, which neither drug alone could control, much has been learned about the management of hypertension from the use of new antihypertensive agents in man and from clinical trials of antihypertensive regimens. Some of this information includes: the unexpected yet very real hazards as well as benefits associated with the long-term use of powerful drugs, in particular the original description of hydralazine-induced lupus, its relation to genetic markers and its association with control of hypertension; the apparently decreasing need for antihypertensive drugs in subjects with well-controlled severe and moderate hypertension; the identification of risk factors for the complications of hypertension and the quantitation of their effects; the decrease in the incidence of hypertensive complications associated with the pharmacologic treatment of severe, moderate and, at least, the upper ranges of mild hypertension; the possibility of designing a chemical to block a specific reaction and the realization that it would have broader than expected effects; and the primary prevention of myocardial infarction in very high risk subjects.
authors.forename: H M
authors.initials: HM
authors.lastname: Perry
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D008725:Bis-Trimethylammonium Compounds / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D002740:Chlorothiazide / Q000009:adverse effects; D004232:Diuretics; D005500:Follow-Up Studies; D018738:Hexamethonium; D006584:Hexamethonium Compounds / Q000009:adverse effects; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced; D009203:Myocardial Infarction / Q000517:prevention & control; D012110:Reserpine / Q000009:adverse effects; D012306:Risk; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents; D008725:Bis-Trimethylammonium Compounds; D002121:Calcium Channel Blockers; D004232:Diuretics; D006584:Hexamethonium Compounds; D049993:Sodium Chloride Symporter Inhibitors; D006830:Hydralazine; D018738:Hexamethonium; D002740:Chlorothiazide; D012110:Reserpine; D002216:Captopril