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Sound Clinical Advice for Hypertensive Patients

Cynthia Mulrow, MD, MSc
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Deputy Editor

Disclaimer: In the past 3 years, Dr. Mulrow served as a site investigator of a multicenter hypertension trial funded by a pharmaceutical agency. She has not received honoraria or funds to attend conferences from pharmaceutical agencies in the past 3 years.

Current Author Address: Cynthia Mulrow, MD, MSc, Department of Medicine, Mail Code 7879, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900.

Ann Intern Med. 2001;135(12):1084-1086. doi:10.7326/0003-4819-135-12-200112180-00013
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In this issue, two perspectives highlight recent evolutions of thought regarding pharmacologic treatment for people with hypertension (12). Furberg and associates remind us that “antihypertensive” drugs have multiple physiologic and clinical effects, some of which are independent of effects on blood pressure. Because blood pressure has limited value as a surrogate marker for clinical effects, it is not optimal to test, select, or approve drugs based solely on their efficacy in lowering blood pressure (1). Kaplan summarizes clinical trial evidence that shows that both blood pressure lowering (to a target <130/80 mm Hg) and therapy with specific agents (angiotensin-converting enzyme inhibitors and diuretics) are beneficial therapeutic approaches for hypertensive adults with diabetes (2).

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