New approaches to the treatment of hypertension

In the past, therapy of hypertension has not provided protection against coronary heart disease. The possible reasons are multiple and likely will never be fully ascertained. Nonetheless, numerous changes in therapy can be made that should reduce coronary risk. These include more careful monitoring of the blood pressure with particular care for control of high levels during the early morning hours; attention to all alterable risk factors with care to avoid worsening of other risks with antihypertensive drugs; adroit use of nondrug therapies; and, when drugs are used, the pressure should be lowered slowly and only to a level that avoids coronary hypoperfusion.