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(Circulation. 2004;109:2953-2958.)
© 2004 American Heart Association, Inc.

Review: Clinical Cardiology: New Frontiers

Hypertensive Therapy: Part I

Veronica Franco, MD; Suzanne Oparil, MD; Oscar A. Carretero, MD

From the Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham (V.F., S.O.), and the Hypertension and Vascular Research Division, Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan (O.A.C.).

Correspondence to Veronica Franco, MD, ZRB 1024, 703 19th St South, University of Alabama at Birmingham, Birmingham, AL 35294. E-mail vfranco@uab.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Cardiovascular disease (CVD), including stroke, is the most common cause of death and disability in developed countries, and hypertension is one of the most important modifiable risk factors for these outcomes.¹ The relationship between blood pressure (BP) and CVD mortality is positive, strong, continuous, graded, and predictive, for those with or without coronary heart disease, and it increases with age.^2,3 A meta-analysis of observational studies involving more than 1 million individuals without prior histories of stroke or heart disease carried out by the Prospective Studies Trialists’ Collaboration demonstrated that death from coronary heart disease and stroke increases continuously and linearly from BP levels as low as 115 mm Hg systolic and 75 mm Hg diastolic.³ An increment of 20 mm Hg in systolic BP (SBP) or 10 mm Hg in diastolic BP (DBP) in middle-aged and elderly persons is associated with a 2-fold increase in cardiovascular (coronary heart disease and stroke) mortality throughout the entire range of BP (Figure 1). In addition, data from the Framingham Heart Study showed that, when compared with "optimum" BP (SBP <120 mm Hg and DBP <80 mm Hg), "normal" BP (SBP 120 to 129 mm Hg or DBP 80 to 84 mm Hg) is associated with a 2- to 4-fold increase in risk of developing hypertension, and "high normal" BP (SBP 130 to 139 mm Hg or DBP 85 to 89 mm Hg) is associated with a 5-fold increased risk.⁴

View larger version (28K): [in this window] [in a new window]   Figure 1. Coronary heart disease (A) and stroke (B) mortality rate in . . . [Full Text of this Article]