Copyright © 1996 by the European Society of Cardiology.
© 1996 1996 The European Society of Cardiology
Benefit and costs of anti-hypertensive treatment
Cattedra Medicina Interna and Centro di Fisiologia Clinica e Ipertensione, Università di Milano and Ospedale Sun Gerardo di Monza; Centro Auxlopico Italiano Milano, Italy
Correspondence: Professor Giuseppe Mancia, Medicina Interna I, Ospedale San Gerardo dei Tintori, via Donizetti 106, Monza, Italy
Hypertension is common throughout the world and represents the single greatest risk factor for increasing cardiovascular mortality, cardiovascular morbidity and overall mortality. Diseases associated with hypertension are not only, in general, of a chronic disabling nature, but, in most instances, require frequent hospitalization, with expensive drug treatment and management. Stroke, coronary heart disease, congestive heart failure and chronic renal insufficiency represent the most commonly encountered corollaries of inadequately treated hypertension. Anti-hypertensive treatment is accompanied by a reduction of hypertension-related cardiovascular risk and a clearcut benefit in terms of reduced incidence of major cardiovascular complications of hypertension and overall mortality. This benefit has frequently been underestimated in many clinical trials. Attempts to improve the cost-benefit ratio have included the use of treatment strategies based upon 24-h control of blood pressure, since it has been demonstrated that hypertension-related end-organ damage correlates more closely with 24-h average blood pressure and with 24-h blood pressure variability than with blood pressure measured in the clinic. It is hoped that new anti-hypertensive agents, which smoothly reduce 24-h blood pressure profile, will further reduce the incidence of hypertension-related end-organ damage.
Key Words: Hypertension • benefit/cost treatment • prevention of mortality