Hypertension update

Abstract

Background: National Health Care Issues-II deals with two reports of tremendous importance to national health, the results of the Systolic Hypertension in the Elderly Program (SHEP) and the results of the Trials of Hypertension Prevention, Phase I (TOHP-I). Both of these issues have tremendous impact on the systemic and ocular morbidity and mortality associated with hypertension.

Methods: The SHEP report addresses the effects of treatment of isolated systolic hypertension (+160 mmHg) in patients 60 years of age and older.

Results: The results indicate that stepped-treatment (initially with a low dosage of chlorthalidone) of these levels of systolic blood pressure had a positive effect on morbidity and mortality. The TOHP-I report addressed the short term feasibility and efficacy of modification of blood pressure by seven non-pharmacologic interventions (LIFE STYLE MODIFICATION).

Conclusions: Contrary to popular beliefs and myths, the only significant blood pressure reductions were attained with modest reductions in weight and sodium intake. These reductions translate to decreased morbidity and mortality.