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Lifelong Management of Hypertension

  • H. Mitchell PerryJr.

Part of the Developments in Cardiovascular Medicine book series (DICM, volume 26)

Table of contents

  1. Front Matter
    Pages I-X
  2. Introduction

    1. H. Mitchell Perry
      Pages 1-5
  3. Epidemiology

  4. Pharmacology of antihypertensive agents

  5. How and whom to treat

    1. George N. Aagaard
      Pages 109-115
    2. H. Mitchell Perry Jr.
      Pages 116-136
    3. Andrew J. Lonigro
      Pages 137-149
  6. Prevention of hypertension and its complications

    1. H. Mitchell Perry Jr., William H. Neal
      Pages 150-170
    2. James Foerster
      Pages 171-180
    3. Sol Sherry
      Pages 181-202
    4. Greta H. Camel, Michael J. Gast, H. Marvin Camel
      Pages 203-228
  7. Hypertension as a problem for society

    1. W. Mcfate Smith
      Pages 229-239
    2. William B. Stason
      Pages 250-260
  8. Back Matter
    Pages 261-268

About this book

Introduction

In the thirty years since the advent of efTective pharmacologic treatment for hypertension, the world ofthe hypertensive has been transformed beyond recog­ nition. The first change involved only malignant hypertensives with enough residual renal parenchyma to survive. Such a hypertensive could trade inevitable renal failure - unless an intracerebral bleed occurred first - for a rigid regimen which prevented his blood pressure from destroying him but which was asso­ ciated with nearly intolerable side effects. Over the next 20 years, increasing numbers of patients with hypertension of decreasing severity were treated with drugs that had fewer and fewer side effects. In 1970, with the medical world finally ready to accept the concept, the well-known Veterans Administration Study demonstrated that morbidity and mortality could be diminished in mode­ rately hypertensive patients by antihypertensive therapy that had minimal side effects. As a result there has been a major attempt to bring everyone with elevated blood pressure under lifelong pharmacologic control. It is difficult, however, to know what levels ofblood pressure deserve treatment; many who, when therapy first became available, would not have even been considered hypertensive are now candidates for treatment. The lower the pressure, the larger the potential population to be treated, but the smaller the individual risk and hence the smaller the possible benefit. The point where decades of diminished quaiity of life from treatment begins to outweigh a possible late-life complication is yet to be de­ termined.

Keywords

drugs heart heart failure hypertension platelet

Editors and affiliations

  • H. Mitchell PerryJr.
    • 1
    • 2
  1. 1.U.S. Veterans AdministrationUSA
  2. 2.Hypertension Division Department of MedicineWashington University School of MedicineSaint LouisUSA

Bibliographic information

  • DOI https://doi.org/10.1007/978-94-009-6732-8
  • Copyright Information Springer Science+Business Media B.V. 1983
  • Publisher Name Springer, Dordrecht
  • eBook Packages Springer Book Archive
  • Print ISBN 978-94-009-6734-2
  • Online ISBN 978-94-009-6732-8
  • Series Print ISSN 0166-9842
  • Buy this book on publisher's site