General considerations when treating hypertension.

Numerous intervention studies have clearly demonstrated the value of antihypertensive treatment. By lowering diastolic blood pressure 5 to 6mm Hg in middle-aged hypertensive patients, a 42% reduction in stroke morbidity and a 14% reduction in coronary heart disease morbidity can be obtained. Recently published large intervention trials have shown that antihypertensive treatment provides even greater benefits in elderly hypertensive patients. Not only are cardiovascular morbidity and mortality reduced, but, in the 'old elderly', total mortality is reduced when blood pressure is lowered. It is conceivable that even better outcomes will be achieved with newer antihypertensive therapies, such as calcium antagonists and angiotensin converting enzyme inhibitors, and this possibility is being investigated in large prospective intervention trials.