The Therapeutic Trials
There are two types of therapeutic trials used in the field of hypertension. Most are short-term trials of antihypertensive drugs compared with placebos or other agents, carried out to demonstrate the efficiency and safety of the drug being tested in reducing elevated blood pressure. The trials reviewed in this chapter are of the second type, those that evaluate the long-term benefit of blood pressure reduction in preventing the morbidity and mortality associated with elevated blood pressure. Although fewer in number, these therapeutic trials have established the value of treating hypertension, have defined the level of elevated blood pressure above which treatment is warranted, and have instigated the widespread public health approach to the treatment of hypertension, which is epitomized by the National High Blood Pressure Education Program of the National Heart, Lung, and Blood Institute. Since 1972, the death rates for stroke and coronary heart disease have declined by more than 60% and 40%, respectively. It is reasonable to assume that better identification of persons with elevated blood pressure and more vigorous treatment inspired by these trials have contributed significantly to this result.
KeywordsCoronary Heart Disease Diastolic Blood Pressure Hypertension Optimal Treatment Hypertension Detection Medical Research Council Working Party
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