Volume 1, Number 2, December 2000

Hypertension and its management: a problem in need of new treatment strategies
Joel M Neutel

It is thus becoming clear that the disappointing reduction in the incidence of coronary artery disease in treated hypertensives is a result both of inadequate BP control and the fact that we are not treating hypertension as a multifactorial syndrome. Our selection of drugs for the management of these patients will be crucial in improving these findings. Our focus should be on selecting drugs that reduce BP, but that also have a positive, or at least a neutral, effect on other cardiovascular risk factors. In addition, we should aggressively manage other cardiovascular risk factors in hypertensive patients, as it has been shown that they are synergistic in their ability to cause heart disease. This comprehensive approach is likely to result in a greater impact on cardiovascular disease in hypertensive patients.
Over the next few years, physicians will need to target therapy more specifically to ensure they use drugs that not only reduce BP, but that are also beneficial in terms of other cardiovascular risk factors. Only then will there be a reduction in the incidences of coronary artery disease.

JRAAS 2000;1:10-13.

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