Management of essential hypertension.
BACKGROUND
Epidemiological studies have unequivocally shown that hypertension (HT)is a major cardiovascular (CV) risk factor and that a direct linear relationship exists between the severity of the blood pressure (BP) elevation and the occurrence of CV events.


RESULTS
The beneficial effects of the BP-lowering interventions have been recognized since a number of years. These include not only the reduction in CV morbidity and mortality but also the regression (or the delay of progression) of HT-related end-organ damage, such as left ventricular hypertrophy, vascular remodelling, endothelial dysfunction and renal damage. Along with these well-established features, antihypertensive drug treatment still faces a number of unmet goals and unanswered questions, such as the target BP values to achieve in high-risk patients, the threshold of treatment in low-risk patients as well as the choice of the therapeutic approach more likely to offer greater CV protection.


CONCLUSIONS
Despite unmet goals, antihypertensive treatment has provided throughout the years successful results. Future efforts will be need to achieve a better BP control in the population and thus to obtain a greater CV protection.
Clinica Medica, Dipartimento di Medicina Clinica e Prevenzione, Università Milano, Milan, Italy. giuseppe.mancia@unimib.it
Giuseppe
G
Mancia
Guido
G
Grassi
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019468:Disease Management; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008019:Life Style; D010349:Patient Compliance
D000959:Antihypertensive Agents