Hypertension is a common condition and is estimated to exist in over 50 million Americans (1). It is probably the most commonly treated chronic condition dealt with by primary care physicians. This observation represents a marked change from the days when only severe hypertension was considered worthy of treatment, and reflects a growing appreciation of the cardiovascular risks associated with even modest elevations of blood pressure.


High Blood Pressure Essential Hypertension Antihypertensive Therapy Beta Blocker Ambulatory Blood Pressure Monitoring 
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  1. 1.
    Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure: The Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med 153: 154–183, 1993.CrossRefGoogle Scholar
  2. 2.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents: Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressure averaging 90 through 114 mmHg. JAMA 213: 1143 1151, 1970.Google Scholar
  3. 3.
    Medical Research Council Working Party: MRC trial of treatment of mild hypertension: principal results. Br Med J 291: 97104, 1985.Google Scholar
  4. 4.
    Report by the Management Committee: The Australian Therapeutic Trial in Mild Hypertension. Lancet 1: 1261–1267, 1980.Google Scholar
  5. 5.
    Stamler J, Stamler R, Neaton JD: Blood pressure and diastolic, and cardiovascular risks. U.S. Population Data. Arch Intern Med 153: 598–615, 1993.PubMedCrossRefGoogle Scholar
  6. 6.
    Franklin SF, Weber MA: Measuring hypertensive cardiovascular risk: the vascular overload concept. Am Heart J,in press.Google Scholar
  7. 7.
    Sutton-Tyrrell K et al.: Stroke 24: 355, 1993.PubMedCrossRefGoogle Scholar
  8. 8.
    Probstfield JL, Furberg CD: Systolic hypertension in the elderly: controlled or uncontrolled. In. ED Frohlich, ed, Preventive Aspects of Coronary Heart Disease. FA Davis Philadelphia, pp 65–84, 1990.Google Scholar
  9. 9.
    Hansson L: What are we really achieving with long-term drug therapy. Am J Hypertens 1: 414–420, 1988.PubMedCrossRefGoogle Scholar
  10. 10.
    Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 265:3255-3264, 1991.Google Scholar
  11. 11.
    MRC Working Party: Medical Research Council Trial of Treatment of Hypertension in Older Adults: principal results. Br Med J 304: 405–412, 1992.CrossRefGoogle Scholar
  12. 12.
    Dahlof B, Lundholm L, Hansson L, et al.: Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 338: 1281–1285, 1991.PubMedCrossRefGoogle Scholar
  13. 13.
    Alderman MH, Madhavan S, Ooi WL, et al.: Association of the renin-sodium profile with the risk of myocardial infarction in patients with hypertension. N Engl J Med 324: 1098–1104, 1991.PubMedCrossRefGoogle Scholar
  14. 14.
    Reaven GM: Role of insulin resistance in human disease (1988 Banting Lecture). Diabetes 37: 1595–1607, 1989.CrossRefGoogle Scholar
  15. 15.
    Kaplan NM: The deadly quartet: upper body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 139: 1514–1520, 1989.CrossRefGoogle Scholar
  16. 16.
    Agnoli A, Manfredi M, Mossuto L, Piccinelli A: Rapport entre les rythmes hemeronyctaux de la tension arterielle et sa pathogenic de I'insuffisance vasculaire cerebrale. Rev Neurol 131: 597–606, 1975.PubMedGoogle Scholar
  17. 17.
    Meyers A, Dewar HA: Circumstances attending 100 sudden deaths from coronary artery disease with coroners' necropsies. Br Heart J 37: 1133–1143, 1975.CrossRefGoogle Scholar
  18. 18.
    Neutel JM, Smith DHG, Graettinger WF, Weber MA: Heredity and hypertension. Impact on metabolic characteristics. Am Heart J 124: 435–440, 1992.PubMedCrossRefGoogle Scholar
  19. 19.
    Hjerman I, Helgeland A, Holme I: J Epidemiol Community Health 32: 117–124, 1978.CrossRefGoogle Scholar
  20. 20.
    Sammelsson O, Wilmhelmsen L, Anderson OK, Pennert K, Berglund G: Cardiovascular morbidity in relation to change in blood pressure and serum cholesterol levels in treated hypertension. JAMA 285: 1768–1776, 1987.Google Scholar
  21. 21.
    Modan M, Halkin H, Lusky A, Segal P, Fuchs Z, Chetrit A: Hyperinsulinemia is characterized by jointly disturbed plasma VLDL, LDL, and HDL levels, Arteriosclerosis 8: 227–236, 1988.PubMedCrossRefGoogle Scholar
  22. 22.
    Swislocki ALM, Hoffman BB, Reaven GM: Insulin resistance, glucose intolerance and hyperinsulinemia in patients with hypertension. Am J Hypertens 2: 419–423, 1989.PubMedGoogle Scholar
  23. 23.
    Ferrannini E, Buzzigoli G, Bonadonna R, et al.: Insulin resistance in essential hypertension. N Engl J Med 320: 702–706, 1989.CrossRefGoogle Scholar
  24. 24.
    Falkner B, Hulman S, Tannenbaum J, Kushner H: Insulin resistance and blood pressure in young black men. Hypertension 15: 705–711, 1990.Google Scholar
  25. 25.
    Reaven GM: Insulin resistance, hyperinsulinemia, and hypertriglyceridemia in the etiology and clinical course of hypertension. Am J Med 90 (Suppl 2A): 7S–12S, 1991.PubMedCrossRefGoogle Scholar
  26. 26.
    Zavaroni I, Bonora E, Pagliara M, et al.: Risk factors for coronary artery disease in health persons with hyperinsulinemia and normal glucose tolerance. N Engl J Med 320: 702–706, 1989.PubMedCrossRefGoogle Scholar
  27. 27.
    Stamler R, Stamler J, Schoenberger JA, et al.: Relationship of glucose tolerance to prevalence of ECG abnormalities and to 5-year mortality from cardiovascular disease: findings of the Chicago Heart Association Detection Project in Industry. J Chronic Dis 32: 817–828, 1979.PubMedCrossRefGoogle Scholar
  28. 28.
    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP: Left ventricular mass and incidence of coronary heart disease in an elderly cohort: the Framingham Heart Study. Ann Intern Med 110: 101–107, 1989.PubMedCrossRefGoogle Scholar
  29. 29.
    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP: Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322: 1561–1566, 1990.PubMedCrossRefGoogle Scholar
  30. 30.
    Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH: Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114: 345–352, 1991.PubMedCrossRefGoogle Scholar
  31. 31.
    Celentano A, Galderisi M, Garofalo M, et al.: Blood pressure and cardiac morphology in young children of hypertensive subjects. J Hypertens 6 (Suppl 4): S107–S109, 1988.Google Scholar
  32. 32.
    Graettinger WF, Neutel JM, Smith DHG, Weber MA: Left ventricular diastolic filling alterations in normotensive young adults with a family history of systemic hypertension. Am J Cardiol 68: 51–56, 1991.PubMedCrossRefGoogle Scholar
  33. 33.
    Weber MA, Smith DHG, Neutel JM, Graettinger WF: Arterial properties of early hypertension. J Hum Hypertens 5: 417423, 1991.Google Scholar
  34. 34.
    Neutel JM, Smith DHG, Graettinger WF, Weber MA: Dependency of arterial compliance on circulating neuroendocrine and metabolic factors in normal subjects. Am J Cardiol 69: 1340–1344, 1992.PubMedCrossRefGoogle Scholar
  35. 35.
    Grunfeld B, Perelstein E, Simsolo R, Gimenez M, Romero JC: Renal function reserve and microalbuminuria in offspring of hypertensive parents. Hypertension 15: 257–261, 1990.PubMedCrossRefGoogle Scholar
  36. 36.
    Van Hooft IMS, Grobbee DE, Derkx FHM, de Leeuw PW, Schalekamp MADH, Hofman A: Renal hemodynamics and the renin-angiotensin-aldosterone system in normotensive subjects with hypertensive and normotensive parents. N Engl J Med 324: 1305–1311, 1991.PubMedCrossRefGoogle Scholar
  37. 37.
    Drayer JIM, Weber MA, Nakamura DK: Automated ambulatory blood pressure monitoring: a study in age-matched normotensive and hypertensive men. Am Heart J 109: 1334–1338, 1985.PubMedCrossRefGoogle Scholar
  38. 38.
    Weber MA, Cheung DG, Graettinger WF, Lipson JL: Characterization of antihypertensive therapy by whole-day BP monitoring. JAMA 259 (22): 3281–3285, 1988.PubMedCrossRefGoogle Scholar
  39. 39.
    Lewis EJ, Hunsicker LG, Bain RP, et al.: The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med 329: 1456–1462, 1993.PubMedCrossRefGoogle Scholar
  40. 40.
    MacMahon S, Peto R, Cutler J, Collin R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J: Blood pressure, stroke and coronary heart disease. Part I: prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335: 765–774, 1990.PubMedCrossRefGoogle Scholar
  41. 41.
    Deedwania PC, Nelson JR: Pathophysiology of silent myocardial ischemia during daily life. Circulation 82: 1296–1304, 1990.PubMedCrossRefGoogle Scholar
  42. 42.
    Ekbom T, Dahlof B, Hansson L, Lindholm L, Oden A, Schersten B, Wester PO: The stroke preventive effect in elderly hypertensives cannot fully be explained by the reduction in office blood pressure-Insights from the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Blood Pressure 1: 168–172, 1992.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Michael A. Weber
    • 1
  1. 1.Hypertension Center—W130 Veterans Affairs Medical CenterLong Beach and the University of CaliforniaIrvine, Long BeachUSA

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