Abstract
Chronic hypertension is associated with an increased morbidity and mortality due to target organ damage (heart, brain, kidneys). In particular, cardiac complications including coronary heart disease (CHD), angina, myocardial infarction (MI), systolic and diastolic congestive heart failure (CHF), and left ventricular hypertrophy (LVH) are increased in all degrees of hypertension. The drug treatment of mild to moderate hypertension (diastolic blood pressure [DBP] ≤ 110 mmHg) has not reduced CHD or other atherosclerotic complications associated with hypertension [1]. Trials that included patients with DBP ≥ 110 mmHg have had reductions in CHD. Although CHD has declined in the United States, this is due primarily to reduction in other risk factors such as hypercholesterolemia, smoking, and severe hypertension (DBP ≥ 115 mmHg) as well as reduction in deaths related to acute MI, but not specifically to the drug treatment of mild hypertension [2].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Cutler JA, MacMahon SW, Furberg CD. Controlled clinical trials of drug treatment for hypertension: A review. Hypertension 1989; 13 (Suppl.I): I36–I44.
Goldberg RJ, Gore JM, Alpert JS, et al. Recent changes in attack and survival rates of acute myocardial infarction (1975 through 1981). The Worcester Heart Attack Study. JAMA 1986; 255: 2774–79.
Houston MC. Hypertension strategies for therapeutic intervention and prevention of end organ damage. Primary Care 1991; 18 (3): 713–53.
Nilsson P, Lindholm L, Schersten B. Hyperinsulinemia and other metabolic disturbances in well-controlled hypertensive men and women. An epidemiological study of the Dalby population. J Hypertens 1990; 8: 953–59.
MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke and coronary heart disease. Part I. Prolonged differences in blood pressure Prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–74.
SHEP Cooperative Research Group. 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 1991; 265: 3255–64.
Medical Research Council Trial of Treatment of Hypertension in Older Adults: Principal results. Br Med J 1992; 304: 405–12.
Dahlof B, Lindholm LH, Hansson L, Schersten B, Ekbom T, Webster P. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet 1991; 338: 1281–85.
Can SJ, Thomas TH, Laker M, et al. Elevated sodium-lithium countertransport: A familial marker of hyperlipidemia and hypertension? J Hypertens 1990; 8: 139–46.
Postnov YV. An approach to the explanation of cell membrane alteration in primary hypertension. Hypertension 1990; 15 (3): 332–37.
Ives HE. Ion transport defects and hypertension-where is the link? Hypertension 1989; 14: 590–97.
Folkow BP. “Structural Factor” in primary and secondary hypertension. Hypertension 1990; 16: 89–101.
Safar ME, Bouthier JA, Levenson JA, et al. Peripheral large arteries and the response to antihypertensive treatment. Hypertension 1983; 5(Suppl. III): III63–III68.
Houston, MC. New insights and approaches to reduce end organ damage in the treatment of hypertension: Subjects of hypertension approach. Am Heart J 1992; 123: 1337–67.
Houston, MC. New insights and approaches for the treatment of essential hypertension: Selection of therapy based on coronary heart disease risk factor analysis, hemodynamic profiles, quality of life, and subsets of hypertension. Heart J 1989; 117 (4): 911–51.
Hilleman DE, Mohiuddin SM, Lucas D Jr, et al. Cost minimization analysis of initial antihypertensive therapy in patients with mild to moderate essential diastolic hypertension. Abstract. Circulation 1992: 88 (Part2): 263.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Houston, M.C. (1998). Hypertension and Coronary Heart Disease Risk Factor Management. In: Gotto, A.M., Lenfant, C., Paoletti, R., Catapano, A.L., Jackson, A.S. (eds) Multiple Risk Factors in Cardiovascular Disease. Medical Science Symposia Series, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5022-4_38
Download citation
DOI: https://doi.org/10.1007/978-94-011-5022-4_38
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-6108-7
Online ISBN: 978-94-011-5022-4
eBook Packages: Springer Book Archive