Hypertension--when is the clinical problem solved? When patients are rendered normotensive.
Hypertension is usually symptomless and associated with little or no alterations in well-being. However, conclusive evidence demonstrates that hypertension is a major risk factor for cardiovascular disease. A reduction of the elevated blood pressure with antihypertensive medication can reduce this risk, but not to that of a normotensive patient. Furthermore, antihypertensive treatment is more effective against stroke and congestive heart failure than against coronary heart disease. Antihypertensive treatment is costly due to its extensive use and life-long indication. Future progress in this area will aim to identify those hypertensive patients at greatest risk of cardiovascular disease, in order to limit treatment to those patients who may benefit most. This paper will consider the effects of blood pressure reduction on cardiovascular morbidity and mortality, the differing effects of antihypertensive treatment on the complications of hypertension, and how antihypertensive therapy can be optimized.
Mancia
G
G
Division of Internal Medicine, San Gerardo Hospital, Monza, University of Milan, Italy.
Lanfranchi
A
A
Cattaneo
B M
BM
Grassi
G
G
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors
D000959:Antihypertensive Agents