Can prevention of hypertension work?
In this article, the clinical trials that have most effectively demonstrated the effectiveness of hypertension nonpharmacologic prevention interventions are presented and discussed. Thus, data from weight reduction, dietary interventions, and lifestyle modifications are shown and discussed. It is concluded that these interventions lead to control of hypertension either by themselves or in association with pharmacologic interventions. Over the years, many controlled clinical trials have demonstrated the efficacy of pharmacologic treatment of hypertension. However, such treatment has its shortcomings. First, it usually requires a lifelong commitment to therapy because, although this approach can control hypertension and reduce its consequences, it does not cure the condition. Next, the cost of pharmacologic interventions can be very high and, thus, prohibitive for poorer individuals and nations. In addition, many patients experience problems with compliance and adherence, which almost certainly contribute to the low level of hypertension control that is so widely observed. Finally, the pharmacologic approach requires a strong commitment by public health officials for detection and treatment of hypertension if there is to be any hope of limiting this condition's impact. All of these negative considerations are compounded by the fact that the prevalence of hypertension is increasing worldwide. For all these reasons, nonpharmacologic interventions should be implemented to prevent or delay the occurrence of hypertension.
Lenfant
Claude
C
World Hypertension League, and National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. lenfantc@prodigy.net
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018849:Controlled Clinical Trials as Topic; D004032:Diet; D015444:Exercise; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000517:prevention & control*; D008019:Life Style; D010349:Patient Compliance; D015431:Weight Loss
D000959:Antihypertensive Agents