Essential Hypertension: Current Needs and Methodological Problems with Non-pharmacological Treatment
Epidemiological studies have shown that a significant proportion of the population have diastolic blood pressures above 100 mmHg even on rechecking. Trials from many countries demonstrate that treatment of such patients with hypotensive drugs reduces the risk of stroke, heart failure and renal failure.1,2,3,4 The benefit in terms of a reduced risk of myocardial infarction is smaller but an overview of the trials shows that even this disorder may be reduced by about 14%.5 Thus, the detection and treatment of people with high blood pressure represents one of the major challenges in the prevention of cardiovascular disease. Reduction in blood pressure may be achieved by means other than drug treatment such as weight loss, restricting excess alcohol intake and cutting back on salt consumption. Further benefit may be gained by getting patients to quit smoking thus preventing added cardiovascular damage. In normal practice pharmacological treatment would only be initiated if the blood pressure remains elevated despite such measures.
KeywordsPlacebo Stratification Washout Atenolol Ketanserin
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