Evidence that has been or should be considered for guidelines on antihypertensive treatment

Guidelines on antihypertensive drug treatment were first issued in the '70s by the American Joint National Committee and by the World Health Organization/International Society of Hypertension (WHO/ISH). They are updated periodically to allow for the effective treatment of high blood pressure. This paper will examine the importance of the results of clinical trials of antihypertensive treatment on hypertension guidelines. It will also examine the reasons why case-control and cohort studies should be interpreted with caution when guidelines are issued. Finally, the importance of surrogate endpoints for morbid and fatal events - such as the regression of left ventricular hypertrophy or early signs of renal damage - will be highlighted