title: Are current strategies for treating hypertension effective?
abstract: The ultimate goal of hypertension management is to prevent or reverse target organ damage and thereby to reduce cardiovascular and renal morbidity and mortality. Over the past two decades, abundant data from population-based, randomized, controlled trials have demonstrated the clinical benefits of blood pressure reduction for individuals with hypertension. Yet a large majority of patients with high blood pressure fail to receive optimal medical management for their hypertension. It appears that a leading obstacle to achieving blood pressure control in the general population is the failure of health care providers to treat high blood pressure sufficiently early, intensively, and persistently. In the past decade, there have been several paradigm shifts in the management of high blood pressure, including: 1). actively intervening to encourage therapeutic lifestyle changes; 2). conducting more comprehensive cardiovascular risk assessments; 3). achieving and maintaining a target blood pressure that is determined by the individuals level of risk; 4). placing a greater emphasis on lowering systolic blood pressure, particularly in older adults; and 5). increasing the use of multidrug therapy, given either as separate components or in the form of a fixed-dose combination, to achieve blood pressure goals. Primary care providers need to heighten their awareness of factors contributing to cardiovascular risk, recognize the very early markers of target organ damage, and set blood pressure goals that are individualized to a patients unique risk profile.
authors.affiliation: Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298-0160, USA. dsica@hsc.vcu.edu
authors.forename: Domenic A
authors.initials: DA
authors.lastname: Sica
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents