The control of hypertension: A therapeutic breakthrough

The developments responsible for this therapeutic breakthrough can be considered in this sequence: the recognition of the importance of even mild hypertension as a cardiovascular risk factor, the unraveling of enough of the pathophysiology of hypertension to rationalize approaches toward its treatment, the demonstration of the value of therapy in reducing the complications that arise, starting with the most severe forms of the disease and proceeding down to the mildest, and the avalability of both nondrug and drug therapies that are effecive and convenient, making long-term control possible in nearly all cases. These new agents offer the promise of more precise corrective manipulation of the hemodynamic aberrations responsible for hypertension. But, without identification of a single, specific mechanism responsible for hypertension in an individual, exact correction may be impossible. Though current therapy is largely empiric, it often succeeds in reversing the underlying hemodynamic defects while, most important, effectively lowering the blood pressure.