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Currents |15 January 1998

Hypertension Guidelines Promote Aggressive Therapy

Cori Vanchieri

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New guidelines on the management of hypertension depart from earlier recommendations by placing greater emphasis on prevention and advocating aggressive new treatment strategies. The guidelines were released by the National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, Maryland, and developed by the coordinating committee of the NHLBI's National High Blood Pressure Education Program.
“We need to prevent the rise of blood pressure with age, improve control, and recognize the importance of high-normal blood pressure in the development of hypertension,” said committee chair Sheldon G. Sheps, MD, emeritus professor of medicine at the Mayo Clinic in Rochester, Minnesota.
Approximately 50 million U.S. adults have hypertension; nearly three quarters do not control their blood pressure to below 140/90 mm Hg. According to Sheps, after several decades of substantial decreases in age-related deaths from stroke and coronary heart disease, recent data indicate that the rates have begun to plateau and that deaths from stroke may even be increasing. In addition, heart failure has been on a continuous upward slope and endstage renal disease, for which hypertension is the second most common antecedent, has more than doubled since 1982.
Although they agree that the report should help clinicians appreciate the importance of treating hypertension, Curt D. Furberg, MD, PhD, of Bowman Gray School of Medicine in Winston-Salem, North Carolina, and Bruce M. Psaty, MD, PhD, of the University of Washington in Seattle, assert that, in places, the guidelines are less evidence-based than consensus-based (Lancet. 1997; 350:1413-4). Because so much expert opinion was included,...
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Vanchieri C. Hypertension Guidelines Promote Aggressive Therapy. Ann Intern Med. 1998;128:162–164. doi: 10.7326/0003-4819-128-2-199801150-00028

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Published: Ann Intern Med. 1998;128(2):162-164.

DOI: 10.7326/0003-4819-128-2-199801150-00028

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