Treating a usually asymptomatic disease associated with a high risk of cardiovascular and renal complications is obviously a challenge. Although since the 1980s the awareness of the risks of hypertension has markedly increased, the percentage of patients whose blood pressure is controlled at <= 140/90 has remained unchanged (NHanes). This is even more sobering if one realizes that more recent studies in large populations have shown that further blood pressure reduction (e.g. levels below 130/80) are required to preserve renal function in certain high risk groups.


General principles for hypertensive pharmacotherapy