[Hypertension at the threshold of the year 2000: classification, treatment, prevention]

Abstract

Despite the clear benefits of treating established hypertension, this approach alone will not prevent all of the blood pressure-related cardiovascular-renal disease in the community. Primary prevention of hypertension is a natural extension of hypertension treatment which provides opportunity to reduce costly cycle of managing hypertension and its complications. The purpose of this report is to guide practician physicians and health professionals in their care of hypertensive patients. In order to provide specific guidelines, a new classification schema of high blood pressure that includes systolic as well diastolic levels is proposed (source, Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure 1993). Furthermore, recommendations for follow-up based on initial set of blood pressure measurements, life-style modifications and pharmacologic therapy are proposed, suggesting a new treatment algorithm in which diuretics and beta-blockers are preferred as first-choice agents because their confirmed reduction in morbidity and mortality (unless they are contraindicated or unacceptable), but including an expanded list of agents that are suitable for initial monotherapy and guidelines for selecting and individualizing the antihypertensive drug regimen.