Blood pressure reduction as part of the multifactorial approach to treatment of cardiovascular disease

Antihypertensive drug treatment has been unequivocally shown to exert favourable cardiovascular effects by reducing the incidence of (and delaying the occurrence of) major complications of hypertension, i.e. stroke, coronary atherosclerosis, congestive heart failure and renal insufficiency. Evidence has also been provided that the benefits of antihypertensive treatment (1) can be observed not only in diastolic or systo-diastolic hypertensive states but also in isolated systolic hypertensions and (2) are not related to a specific antihypertensive drug regimen but rather to the blood pressure lowering per se. The latter statement has been confirmed by the results of recently published clinical trials, demonstrating the ability of ACE inhibitors and calcium antagonists to exert cardioprotective properties similar to those induced by conventional antihypertensive drug treatment. Recent clinical trials have also shown that further advantages in patient protection can be achieved by lowering diastolic blood pressure values to well below 90 mmHg, particularly when high blood pressure is accompanied by diabetes and renal insufficiency