Responders to antihypertensive treatment: how may they be identified?

The identification of responders to antihypertensive treatment is valuable as an aid to management, in determining the characteristics of a responder and as a measure of treatment efficacy. This paper discusses the various methods of identifying a responder and the factors influencing response, including the placebo factor and regression to the mean. Response is also discussed in terms of fall in systolic and diastolic pressure. Antihypertensive drugs that have a greater effect on systolic pressure rather than on diastolic pressure are identified, for example methyldopa; and drugs with more equal effects on systolic and diastolic pressure, such as verapamil, are also identified. If it is proven that isolated systolic hypertension requires active treatment it is important to identify those drugs with a greater effect on systolic pressure.