Skip to main content
SpringerLink
Log in

Hypertension

  • Chapter
Cardiovascular Disease

Part of the book series: Treatment in Clinical Medicine ((TC MEDICINE))

  • 440 Accesses

Abstract

Our attitude to hypertension has changed dramatically in the past 30 years. This has been reflected in terms of investigation, in terms of medical and surgical management and in the development of hypertension as a speciality. While hypertension developed initially as a hospital-orientated problem, the trend now is towards “shared care” or general practitioner management. The search for aetiology of primary (also known as idiopathic and misleadingly as “essential”) hypertension previously dominated the assessment of patients. Hypertensive patients — young or old, male or female — underwent a battery of investigations such as intravenous pyelography, radio-isotope renography and at times aortography. Complex biochemical investigations were also included. Investigation is now more selective. It is extremely complex when necessary, but overall has become simpler. The need for treatment can be based on general criteria:

  1. Stage 1:

    Raised blood pressure. No organ involvement. Consider therapy.

  2. Stage 2:

    Raised blood pressure. Organ involvement (e.g. LV hypertrophy). Treatment indicated.

  3. Stage 3:

    Raised blood pressure. Organ failure or damage (e.g. cardiomegaly, blood urea raised). Treatment mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Anderson RJ, Hart GR, Grumpier CP, Reed WG, Mathews CA, (1981) Oral Clonidine loading in hypertensive urgencies. JAMA 246: 848–850

    Article  PubMed  CAS  Google Scholar 

  • Aoki K, Kondo S, Mochizuke A, Yoshida T, Kato S, Takikawa K (1978) Antihypertensive effect of cardiovascular Ca++ antagonists in hypertensive patients in the absence and presence of beta adrenergic blockade. Am Heart J 96: 218–226

    Article  PubMed  CAS  Google Scholar 

  • Atkinson AB, Brown JJ, Lever AF, Robertson JIS (1980) Combined treatment of severe intractable hypertension with captopril and diuretic. Lancet II: 105–107

    Article  Google Scholar 

  • Bayley S, Dobbs PJ, Robinsin BF (1982) Nifedipine in the treatment of hypertension: report of a double blind controlled trial. Br J Clin Pharmacol 14: 509–512

    PubMed  CAS  Google Scholar 

  • Beer N, Gallegos I, Cohen A, Klein N, Sonnenblick E, Frishman W (1981) Efficacy of sublingual nifedipine in the acute treatment of systemic hypertension. Chest 79: 571–574

    Article  PubMed  CAS  Google Scholar 

  • Beilin LH, Juel-Jensen BE (1972) Alpha and beta adrenergic blockade in hypertension. Lancet I: 979–982

    Article  Google Scholar 

  • Bertel O, Conen D, Radv EW, Muller J, Lang C, Dubach UC (1983) Nifedipine in hypertension emergencies. Br Med J 286: 19–21

    Article  CAS  Google Scholar 

  • Buhler FR, Laragh JH, Baer L, Vaughan ED, Brunner HR (1972) Propranolol inhibition of rennin secretion. N Engl J Med 287: 1209–1214

    Article  PubMed  CAS  Google Scholar 

  • Buhler FR, Hulthen UL, Kiowski W, Muller FB, Bolli P (1982) The place of the calcium antagonist verapamil in antihypertensive therapy. J Cardiovasc Pharmacol 4 [Suppl]: 350–357

    Article  Google Scholar 

  • Dollery CT, Lewis PJ, Myers MG (1973) Central hypotensive effect of propranolol in the rabbit. Br J Pharmacol 48: 343

    Google Scholar 

  • Editorial (1983) Lancet II: 22–24

    Google Scholar 

  • European Working Party on high blood pressure in the elderly (1985) Mortality and morbidity results from the Working Party on high blood pressure in the elderly trial. Lancet II: 1349-1354

    Google Scholar 

  • Gallery EDM, Saunders DM, Munyor SM, Gyopy AZ (1979) Randomised comparison of methyldopa and oxprenolol for treatment of hypertension in pregnancy. Br Med J I: 1591-1594

    Article  Google Scholar 

  • Goldstein GB, Lam KC, Mistilis SP (1973) Drug induced active chronic hepatitis. Am J Digest Dis 18: 177–184

    Article  PubMed  CAS  Google Scholar 

  • Gould BA, Horning RS, Mann S, Balasubramanian V, Raftery EB (1982) Slow channel inhibitors verapamil and nifedipine in the management of hypertension. J Cardiovasc Pharmacol 4 [Suppl]: 369–373

    Article  Google Scholar 

  • Guidelines for the treatment of mild hypertension: memorandum from a W.H.O./I.S.H. meeting (1983) Lancet I: 457–458

    Google Scholar 

  • Hansson L, Zweifler AJ, Julius S (1974) Propranolol therapy in essential hypertension. Observations on predictability of therapeutic response. Int J Clin Pharmacol 10: 79–86

    PubMed  CAS  Google Scholar 

  • Hoffman BB, Lefkowitz RJ (1980) Alpha-adrenergic receptor subtypes. N Engl J Med 302: 1390-1397

    Article  PubMed  CAS  Google Scholar 

  • Hollifield JW, Sherman K, Vander Zwagg R, Shand DG (1976) Proposed mechanisms of propranolol’s antihypertensive effect in essential hypertension. N Engl Med 295: 68–73

    Article  CAS  Google Scholar 

  • Hutchison S, Campbell LM (1983) Beta-blockers and the elderly. J Clin Hosp Pharm 8: 191–194

    PubMed  CAS  Google Scholar 

  • Hypertension Detection and Follow-up. Program Co-operative Group (1979) Five year findings of the hypertension detection and follow-up program. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 242: 2562–2571

    Article  Google Scholar 

  • Kannel WB (1977) An overview of the risk factors for cardiovascular disease In: Genest S, Koiw E, Kuchel OED (eds) Hypertension, physiopathology and treatment. McGraw Hill, New York

    Google Scholar 

  • Kannel WB, Gordon T (1978) Evaluation of the cardiovascular risk in the elderly: The Framingham Study. Bull N Y Acad Med 54: 573–591

    PubMed  CAS  Google Scholar 

  • Kannel WB, Gordon T, Schwartz MG (1971) Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham Study. Am J Cardiol 27: 335–346

    Article  PubMed  CAS  Google Scholar 

  • Koch-Weser J (1973) Correlation of pathophysiology and pharmacotherapy in primary hypertension. Am J Cardiol 32: 499–510

    Article  Google Scholar 

  • Langer SZ (1976) The role of alpha and beta presynaptic receptors in the regulation of noradrenaline release elicited by nerve stimulation. Clin Sci Sl (Suppl 3): 421–426

    Google Scholar 

  • Ledingham JGG, Rajagopalan B (1979) Cerebral complications in the treatment of accelerated hypertension. Q J Med 48: 25–41

    PubMed  CAS  Google Scholar 

  • Lewis PG, Haeusler G (1975) Reduction in sympathetic nervous activity as a mechanism for hypotensive effect of propranolol. Nature 256: 440

    Article  PubMed  CAS  Google Scholar 

  • Lorimer AR, Barbour M, Hillis WS, Lawrie TDV, Stoker JB, Sreeharan N, Leanage RV, Linden RJ (1980) Long term comparison of metoprolol and methyldopa in the treatment of hypertension. Clin Cardio 3: 36–39

    CAS  Google Scholar 

  • Lowe GDO (1983) Vasodilators: minoxidil and drugs used in peripheral vascular and cerebral disorders. Br Med J 286: 1262–1264

    Article  CAS  Google Scholar 

  • Lund-Johansen P (1970) Haemodynamic changes in long term diuretic therapy of essential hypertension. Acta Med Scand 187: 509–518

    Article  PubMed  CAS  Google Scholar 

  • Lund-Johansen P (1972) Haemodynamic changes in long term alpha methyldopa therapy of essential hypertension. Acta Med Scand 192: 221–226

    Article  PubMed  CAS  Google Scholar 

  • Lund-Johansen P (1979) Haemodynamic consequences of long term beta-blocker therapy: a 5 year follow-up study of atenolol. J Cardiovasc Pharmacol 1: 487–495

    Article  Google Scholar 

  • McAreavey D, Ramsey LE, Latham L, Lorimer AR, McLaren D, Reid JL, Robertson JIS, Robertson MP, Weire RJ (1983) The “third drug” trial. J Hypertension 1 (Suppl 2): 116–120

    CAS  Google Scholar 

  • MacKay A, Isles C, Henderson I, Fife R, Kennedy AC (1981) Minoxidil in the management of refractory hypertension. Q J Med 198: 175–190

    Google Scholar 

  • Management Committee (1980) The Australian therapeutic trial in mild hypertension. Lancet I: 1261–1267

    Google Scholar 

  • Medical Research Council Working Party (1985) MRC trial of treatment of Mild Hypertension: principal results. Br Med J 291: 97–104

    Article  Google Scholar 

  • Morgan T, Adam W, Gillies A, Wilson M, Morgan G, Carney S (1978) Hypertension treated by salt restriction. Lancet I: 227–230

    Article  Google Scholar 

  • Morton JJ, Tree M, Casals-Stenzel J (1982) Effect of infused Captopril on blood pressure and the renin angiotensin aldosterone system in normal dogs subjected to varying sodium balance. Am J Cardiol 49: 1395–1400

    Article  PubMed  CAS  Google Scholar 

  • Motulsky HJ, Insel PA, (1982) Adrenergic receptors in man. N Engl J Med 307: 18–29

    Article  PubMed  CAS  Google Scholar 

  • Motulsky HJ, Snavely MD, Hughes RJ, Insel PA (1983) Interaction of verapamil and other calcium channel blockers with 1 2 adrenergic receptors. Circ Res 52: 226–231

    PubMed  Google Scholar 

  • MRC Working Party on Mild to Moderate Hypertension (1981) Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Lancet II: 539–543

    Google Scholar 

  • Murphy MB, Scriven AJI, Dollery CT (1983) Role of nifedipine in treatment of hypertension. Br Med J 287: 257–259

    Article  CAS  Google Scholar 

  • Olivari MT, Bartorelli C, Polese A, Fiorentini C, Moruzzi P, Guazzi MD (1979) Treatment of hypertension with nifedipine, a calcium antagonistic agent. Circulation 59: 1056–1062

    PubMed  CAS  Google Scholar 

  • O’Malley K, O’Brien E (1980) Management of hypertension in the elderly. N Engl J Med 302: 1397–1401

    Article  PubMed  Google Scholar 

  • Parfrey PS, Markandu ND, Roulston JE, Jones BE, Jones JC, McGregor GA (1981) Relation between arterial pressure, dietary sodium intake and renin system in essential hypertension. Br Med J 283: 94–97

    Article  CAS  Google Scholar 

  • Personal Paper (1977) Trials and tribulations of a symptom-free hypertensive physician receiving the best of care. Lancet II: 291–292

    Google Scholar 

  • Prichard BNC, Gillam PMS (1969) Treatment of hypertension with propranolol. Br Med J I: 7–16

    Article  Google Scholar 

  • Redman CWG, Beilin LJ, Bonnar J, Dunsted MK (1976) Foetal outcome in trial of antihypertensive treatment in pregnancy. Lancet II: 753–756

    Article  Google Scholar 

  • Redman CWG, Beilin LJ, Bonnar J (1977) Treatment of hypertension in pregnancy with methyldopa — blood pressure control and side effects Br J Obstet Gynaecol 84: 419–426

    Article  PubMed  CAS  Google Scholar 

  • Robertson JIS (1982) Labetalol: The nineteen eighties. Br J Clin Pharmacol 13 [Suppl 1]: 137–141

    Google Scholar 

  • Robinson BF, Dobbs RJ, Bayley S (1983) Response of forearm resistance vessels to verapamil and sodium nitroprusside in normotensive and hypertensive men: evidence for a functional abnormality of vascular smooth muscle in primary hypertension. Clin Sci 63: 33–42

    Google Scholar 

  • Rose G (1981) Strategy of prevention: lessons from cardiovascular disease. Br Med J 282: 1847-1851

    Article  CAS  Google Scholar 

  • Rubin PC, Reid JL (1983) Alpha-blockers and converting enzyme inhibitors. Br Med J 286:1192-1195

    Article  CAS  Google Scholar 

  • Rubin PC, Clark DM, Sumner DJ, Low RA, Butters L, Reynolds B, Steedman D, Reid JL (1983) Placebo-controlled trial of atenolol in treatment of pregnancy-associated hypertension. Lancet I: 431–436

    Google Scholar 

  • Sandstrom B (1978) Antihypertensive treatment with the adrenergic beta receptor blocker metoprolol during pregnancy. Gynecol Invest 9: 195–204

    Article  PubMed  CAS  Google Scholar 

  • Taverner D, Bing RF, Heagerty A, Russell GI, Pohl JEF, Swales JD, Thurston H (1983) Improvement of renal function during long term treatment of severe hypertension with minoxidil. Q J Med 206: 280–287

    Google Scholar 

  • Tung LH, Rand MJ, Majewski H (1981) Adrenaline-induced hypertension in rats. Clin Sci 61 (Suppl 7): 191–193

    Google Scholar 

  • Veterans’ Administration Co-operative Study Group (1967) Effects of treatment of morbidity in hypertension. JAMA 202: 1028–1034

    Article  Google Scholar 

  • Veterans’ Administration Co-operative Study Group (1970) Effects of treatment of morbidity in hypertension. Results in patients with diastolic blood pressure averaging 90 through 114 mmHg. JAMA 213: 1143–1152

    Article  Google Scholar 

  • Veterans’ Administration Co-operative Study Group on Antihypertensive Agents (1982) Comparison of propranolol and hydrochlorothiazide for the initial treatment of hypertension. JAMA 248: 1996–2003

    Article  Google Scholar 

  • Vidt DG, Bravo EL, Fouad FM (1982) Captopril. N Engl J Med 306: 214–219

    Article  CAS  Google Scholar 

  • Vilsvik JA, Schannin J (1976) Effect of atenolol on ventilatory function in asthma. Br Med J II: 453–455

    Article  Google Scholar 

  • Walker J, Greer I, Calder AA (1983) Treatment of acute pregnancy-related hypertension: labetalol and hydralazine compared. Postgrad Med J 59 (Suppl 3): 168–170

    PubMed  Google Scholar 

  • Watt GCM, Edwards C, Hart JT, Hart M, Walton P, Foy CW (1983) Dietary sodium restriction for mild hypertension in general practice. Br Med J 282: 432–436

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Royal Infirmary, Castle Street, Glasgow, Scotland, UK

    A. Ross Lorimer MD, FRCP (Consultant Cardiologist)

  2. Stobhill General Hospital, Glasgow, G21 2UW, Scotland, UK

    W. Stewart Hillis MB, FRCP (Senior Lecturer in Clinical Pharmacology and Consultant Cardiologist)

Authors
  1. A. Ross Lorimer MD, FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Stewart Hillis MB, FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1985 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lorimer, A.R., Hillis, W.S. (1985). Hypertension. In: Cardiovascular Disease. Treatment in Clinical Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-3120-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-3120-5_10

  • Publisher Name: Springer, London

  • Print ISBN: 978-3-540-15426-6

  • Online ISBN: 978-1-4471-3120-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation