The Case for Treating Mild Hypertension

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Abstract
Data are presented that define the risks of elevated blood pressure, both systolic and diastolic, and support the recent recommendations of the Third Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure in the United States that a consistently elevated pressure level above 140/90 mm Hg in adults should be lowered if possible. A summary of the major clinical trials, as well as a review of extensive data reported over the past 15-20 years, supports conclusions that mortality and morbidity are reduced, even in the mild hypertensive (diastolic BPs of 90-104 mm Hg), following blood pressure lowering to normotensive levels (less than 140-90 mm Hg). Numerous observations in the 1960s and 70s had established the benefits of treatment in patients with severe hypertension (diastolic BPs more than 115 mm Hg). The Veterans Administration studies also demonstrated that blood pressure lowering in patients with diastolic BPs above 105 mm Hg reduced mortality. More recently the 7-10-year U.S. Public Health Service Study and the Hypertension Detection and Follow-Up Program Study (HDFP) in the United States, and the Australian Study in Mild Hypertension, have demonstrated a decrease in cerebrovascular and a trend of a statistically significant decrease in overall cardiovascular mortality with effective blood pressure lowering.(ABSTRACT TRUNCATED AT 250 WORDS)

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