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A Word of Caution

Richard I. Kopelman, MD; Victor J. Dzau, MD

Arch Intern Med. 1985;145(1):47-49.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The management of mild essential hypertension is a fundamental problem in preventive medicine. Mild hypertension is defined as diastolic BP between 90 and 104 mm Hg. It occurs in an estimated 20% of the adult population or 75% of the 60 million Americans with hypertension. Data from various actuarial tables and the Framingham study¹ clearly indicate increased cardiovascular risks in these subjects. Accordingly, one might predict that treatment to normalize BP would result in substantial benefit. Indeed, several large-scale clinical trials of pharmacologic intervention have shown reductions in cardiovascular and noncardiovascular morbidity and mortality. These studies² have frequently been cited as the rationale for aggressive pharmacologic treatment of mild hypertension. However, drug therapy is costly and frequently produces unacceptable side effects.

The Australian trial³ reported fewer cardiovascular complications in patients whose diastolic BP spontaneously fell below 100 mm Hg while receiving a placebo, compared with patients whose . . . [Full Text PDF of this Article]

Author Affiliations
Division of General Medicine New England Medical Center Tufts University School of Medicine Boston, MA 02111; Hypertension Unit Brigham and Women's Hospital Harvard Medical School Boston, MA 02115

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