Coronary morbidity and mortality, pre-existing silent coronary artery disease, and mild hypertension.

Abstract:

:Experimental findings in animals and epidemiologic studies in humans provide strong evidence that hypertension promotes the onset and progression of atherosclerosis. However, effective antihypertensive therapy has not consistently reduced the incidence of cardiac events in the major trials of treatment for mild hypertension. In reviewing these trials and the recent data on the pathophysiologic interrelationships among hypertension, atherosclerosis, and myocardial ischemia, two factors stand out: First, the power of these trials to produce a positive result was limited because of their size, entry criteria, duration, and other considerations; second, autopsy and epidemiologic data suggest that some patients in these trials probably had advanced coronary artery disease at the time of entry. Because these patients probably developed symptomatic coronary artery disease by virtue of this pre-existing disease, the failure of antihypertensive therapy alone to prevent cardiac events in trials of relatively short duration should not be construed as evidence against its value as a long-term therapy.

journal_name

Ann Intern Med

authors

O'Kelly BF,Massie BM,Tubau JF,Szlachcic J

doi

10.7326/0003-4819-110-12-1017

subject

Has Abstract

pub_date

1989-06-15 00:00:00

pages

1017-26

issue

12

eissn

0003-4819

issn

1539-3704

journal_volume

110

pub_type

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