Lessons in hypertension from new clinical trials.
Three important principles have emerged from recent epidemiologic and clinical studies in hypertension. First, patients with hypertension most often have other cardiovascular risk factors such as obesity and diabetes. Second, hypertension remains grossly undertreated. Third, at blood pressure levels once considered "high-normal," early organ damage may already be taking place in patients with multiple risk factors that, without treatment, can eventually lead to cardiovascular morbidity and mortality. The concept of evaluating global or overall risk is gaining wide acceptance, and US treatment guidelines may soon reflect these findings and assist clinicians in identifying individuals who are most likely to benefit from therapy. Results from clinical trials suggest that among the various pharmacologic agents available to treat hypertension, blockers of the renin-angiotensin system are effective in type 2 diabetes and chronic kidney disease, conditions that often occur in conjunction with hypertension.
Nesbitt
Shawna D
SD
University of Texas Southwestern Medical Center, Dallas, TX 75390-8586, USA. shawna.nesbitt@utsouthwestern.edu
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D014943:Global Health; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D012016:Reference Values
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents