Am J Cardiovasc Dis 2012;2(3):160-170
Review Article
Treatment of systemic hypertension
Wilbert S Aronow
Cardiology Division, Department of Medicine, New York Medical College, Valhalla, New York, USA.
Received April 9, 2012; accepted May 22, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: Systemic hypertension is a major risk factor for cardiovascular disease and is present in 69% of patients with a
first myocardial infarction, in 77% of patients with a first stroke, in 74% of patients with chronic heart failure, and in 60% of
patients with peripheral arterial disease. Double-blind, randomized, placebo-controlled trials have found that
antihypertensive drug therapy reduces cardiovascular events in patients aged younger than 80 years and in patients aged
80 years and older in the Hypertension in the Very Elderly Trial. Although the optimal blood pressure treatment goal has not
been determined, existing epidemiologic and clinical trial data suggest that a reasonable therapeutic blood pressure goal
should be <140/90 mm Hg in patients younger than 80 years and a systolic blood pressure of 140-145 mm Hg if tolerated
in patients aged 80 years and older. Non-pharmacologic lifestyle measures should be encouraged both to prevent
development of hypertension and as adjunctive therapy in patients with hypertension. Angiotensin-converting enzyme
inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics have all reduced
cardiovascular events in randomized trials. The choice of specific drugs depends on efficacy, tolerability, presence of
specific comorbidities, and cost. (AJCD1204001).
Keywords: Hypertension, diuretics, beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor
blockers, calcium channel blockers
Address all correspondence to:
Dr. Wilbert S. Aronow
Cardiology Division, New York Medical College
Macy Pavilion, Room 138
Valhalla, NY 10595, USA.
Tel: (914) 493-5311; Fax number: (914) 235-6274
E-mail: wsaronow@aol.com
Review Article
Treatment of systemic hypertension
Wilbert S Aronow
Cardiology Division, Department of Medicine, New York Medical College, Valhalla, New York, USA.
Received April 9, 2012; accepted May 22, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: Systemic hypertension is a major risk factor for cardiovascular disease and is present in 69% of patients with a
first myocardial infarction, in 77% of patients with a first stroke, in 74% of patients with chronic heart failure, and in 60% of
patients with peripheral arterial disease. Double-blind, randomized, placebo-controlled trials have found that
antihypertensive drug therapy reduces cardiovascular events in patients aged younger than 80 years and in patients aged
80 years and older in the Hypertension in the Very Elderly Trial. Although the optimal blood pressure treatment goal has not
been determined, existing epidemiologic and clinical trial data suggest that a reasonable therapeutic blood pressure goal
should be <140/90 mm Hg in patients younger than 80 years and a systolic blood pressure of 140-145 mm Hg if tolerated
in patients aged 80 years and older. Non-pharmacologic lifestyle measures should be encouraged both to prevent
development of hypertension and as adjunctive therapy in patients with hypertension. Angiotensin-converting enzyme
inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics have all reduced
cardiovascular events in randomized trials. The choice of specific drugs depends on efficacy, tolerability, presence of
specific comorbidities, and cost. (AJCD1204001).
Keywords: Hypertension, diuretics, beta blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor
blockers, calcium channel blockers
Address all correspondence to:
Dr. Wilbert S. Aronow
Cardiology Division, New York Medical College
Macy Pavilion, Room 138
Valhalla, NY 10595, USA.
Tel: (914) 493-5311; Fax number: (914) 235-6274
E-mail: wsaronow@aol.com
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