Prevention of Fatal and Nonfatal Ischemic Heart Disease by Early Treatment of Hypertension

Between 1979 and 1984 two major hypertension intervention studies involving 14,000 patients have demonstrated convincing evidence for the effectiveness of blood pressure reduction on both primary and secondary prevention of ischemic heart disease. Previous treatment trials using insufficient numbers and shorter observation periods had produced inconclusive results as far as coronary heart disease is concerned. More recently, warnings have been voiced that untoward effects of diuretics on serum lipids might possibly harm the hypertensive patient because of transient slight increases of cholesterol levels. In this regard, two antihypertensive treatment studies, one lasting 5 years and the other 6 years, are reassuring as they provide unequivocal proof that there is no undesirable increase in lipid levels. The myocardium and its coronary arteries today appear as the major target organ among patients with untreated hypertension. ‘Mild’ blood pressure elevation is very frequent and, since poorly controlled hypertension was shown to contribute the largest number of cases of fatal and nonfatal ischemic heart disease, it is recommended that the present conservative therapeutic approach tow