Abstract
Epidemiological studies have shown that a significant proportion of the population have diastolic blood pressures above 100 mmHg even on rechecking. Trials from many countries demonstrate that treatment of such patients with hypotensive drugs reduces the risk of stroke, heart failure and renal failure.1,2,3,4 The benefit in terms of a reduced risk of myocardial infarction is smaller but an overview of the trials shows that even this disorder may be reduced by about 14%.5 Thus, the detection and treatment of people with high blood pressure represents one of the major challenges in the prevention of cardiovascular disease. Reduction in blood pressure may be achieved by means other than drug treatment such as weight loss, restricting excess alcohol intake and cutting back on salt consumption. Further benefit may be gained by getting patients to quit smoking thus preventing added cardiovascular damage. In normal practice pharmacological treatment would only be initiated if the blood pressure remains elevated despite such measures.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
European Working Party: Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly Trial. Lancet 1985; 1: 1349
The Management Committee: The Australian therapeutic trial in mild hypertension. Lancet 1980; 1: 1261
Medical Research Council Working Party: MRC trial of treatment of mild hypertension: principal results. Br. Med. J. 1985; 191: 97
Veterans Administration Cooperative Study Group: Effects of treatment on morbidity in hypertension II. Results in patients with diastolic blood pressure averaging 90 through 114mmHg JAMA 1970; 213: 1143
Collins R., Peto R., MacMahon S. et al.: Blood pressure, stroke, and coronary heart disease. 2: Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990; 335: 827
Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24hr urinary sodium and potassium excretion. Br. Med. J. 1988; 297: 319
Watt G.C.M., Edwards C., Hart J.T., Hart M., Walton P., Foy C.J.W.: Dietary sodium restriction for mild hypertension in general practice. Br. Med. J. 1983; 286: 432
Endres S., Ghorboni R., Kelley V.E. et al.: The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin I and tumor necrosis factor by mononuclear cells. New Engl. J. Med. 1989; 320 (5): 265–271
Armitage P.: Should we cross off the crossover ? Br. J. Clin. Pharmac. 1991; 32: 1
Chaput de Saintonge D.M., Evans S.J.W., Vere D.W.: Statistical methods in clinical trials. In Recent Advances in Clinical Pharmacology, London, Edinburgh, Churchill Livingstone 1990; 19–34
O’Brien E., Mee F., Atkins F., O’Malley K.: Inaccuracy of the Hawksley random zero sphygmomanometer. Lancet 1990; 2: 1465
Armitage P., Rose G.A.: The variability of measurements of casual blood pressure. Clin. Sci. 1966; 30: 325
Altman D.G.: Statistics and ethics in medical research. III. How large a sample ? Br. Med. J. 1980; 281: 1336
Freestone S., Silas J.H., Ramsay L.E.: Sample size for short-term trials of antihypertensive drugs. Br. J. Clin. Pharmac. 1982; 14: 265
Bristol D.R.: Sample sizes for constructing confidence intervals and testing hypotheses. Statistics in Medicine. 1989; 8: 803
Cameron H.A., Waller P.C., Ramsay L.E.: Ketanserin in essential hypertension: use as monotherapy and in combination with a diuretic or 13-adrenoceptor antagonist. Br. J. Clin. Pharmac. 1987; 24: 705
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer-Verlag London
About this paper
Cite this paper
Jackson, P.R., Yeo, W.W., Ramsay, L.E. (1992). Essential Hypertension: Current Needs and Methodological Problems with Non-pharmacological Treatment. In: De Caterina, R., Kristensen, S.D., Schmidt, E.B. (eds) Fish Oil and Vascular Disease. Current Topics in Cardiovascular Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-3890-7_14
Download citation
DOI: https://doi.org/10.1007/978-1-4471-3890-7_14
Publisher Name: Springer, London
Print ISBN: 978-1-4471-3892-1
Online ISBN: 978-1-4471-3890-7
eBook Packages: Springer Book Archive