title: Current therapy, present limitations and future goals for systemic hypertension.
abstract: During the past 2 decades, encouraging strides have been made in the recognition and treatment of patients with high blood pressure and in the development of antihypertensive therapy. Concerns surrounding the control of hypertension, however, continue to emerge. As many as two-thirds of hypertensive patients in the US remain inadequately controlled. Although overall cardiovascular mortality has declined since the mid- 1960s, a significant impact of antihypertensive therapy on coronary artery disease morbidity and mortality has not been conclusively demonstrated. Unfavorable metabolic effects associated with traditional step-care antihypertensive therapy with diuretics and beta blockers are increasingly implicated for failure to demonstrate a decrease in coronary artery disease. The availability of newer efficacious antihypertensive therapy that does not adversely affect metabolic parameters is resulting in a reappraisal of traditional step-care. Of particular interest are the calcium channel blockers, because they are efficacious, well tolerated and offer favorable metabolic and hemodynamic profiles. Nitrendipine is a new long-acting member of the 1,4 dihydropyridine class of calcium channel blockers that has shown encouraging results for treatment of hypertension.
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D014481:United States
chemical_list: D000959:Antihypertensive Agents