The endothelium as prognostic factor and therapeutic target: What criteria should we apply?

In the past, the main criterion used to establish both the prognosis of hypertension and the therapeutic goal has been simply blood pressure level. More recently, various expert groups have recommended models to establish overall cardiovascular risk that include other risk factors beyond blood pressure alone. An example is the three-tiered risk classification used in the sixth report of the U.S. Joint National Committee (JNC-6). Based on the overall risk status the decision is made to begin treatment and to decide between lifestyle modifications and antihypertensive drug therapy. In the future, more exact criteria will undoubtedly be used to establish prognosis and therapeutic goals. An easy and accurate assessment of endothelial function could very well serve as one of these criteria.