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(Hypertension. 2007;49:257.)
© 2007 American Heart Association, Inc.

Hypertension Highlights

Clinical Trials for Hypertension

Expectations Fulfilled and Unfulfilled

From the Hypertension Division, Department of Internal Medicine, University of Texas, Southwestern Medical School, Dallas.

Correspondence to Norman M. Kaplan, Hypertension Division, Department of Internal Medicine, University of Texas, Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390. E-mail norman.kaplan@utsouthwestern.edu

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

	Introduction

 
Current projections predict that, by the year 2025, 29.2% of the adult population worldwide will have hypertension, a total of 1.56 billion people.¹ Such figures are hard to visualize, as are the billions of dollars being spent on the Iraqi invasion. Enough to say that hypertension is now and has long been the most common risk for the most common causes of death in all but the most primitive populations in the world.

Despite such knowledge, the disease is poorly treated in almost all countries including the United States despite the increasing availability of effective and innocuous medications.² A detailed analysis of the reasons responsible for our failure to control most hypertension is not the aim of this Hypertension Highlight, but rather the place of randomized, controlled trials (RCTs) in coming to where we are and where we ought to be.

	The Value of RCTs

 
Proof of the life-saving value of treating hypertension has come almost exclusively from RCTs.³ Initially, the study of only small numbers of severely hypertensive patients was needed to show benefit in only a short time; over the years, as progressively milder hypertension was tested, the trials have had to be both larger and longer.

As of late 2006, the value of treating levels of blood pressure (BP) as low as 160 mm Hg systolic and 90 mm Hg diastolic in the overall population has been proved. However, this proof has almost exclusively come from RCTs of patients over age 55 years and, in most trials, with relatively high risk . . . [Full Text of this Article]

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