Does it matter how you lower blood pressure in patients with uncomplicated hypertension? Weighing the evidence.

Arterial hypertension is one of the most important preventable causes of death worldwide; therefore, adequate treatment of high blood pressure should be mandatory in each hypertensive patient. Hypertension is now defined on the basis of systolic and diastolic blood pressure levels and classified into stages on the basis of the degree of elevation. Normal blood pressure is widely considered as being less than 120/80 mm Hg. The presence of risk factors such as elevated blood cholesterol, smoking, diabetes, and obesity greatly increases the risk for hypertension-related morbid events. The physiologic link between vascular health and arterial pressure makes it difficult to separate the adverse effects of pressure and vascular functional and structural alterations in determining the adverse complications of hypertension. Several landmark trials in hypertension treatment have been published in the past few years, providing more evidence-based medicine data regarding optimal treatment of hypertension to reduce cardiovascular morbidity and mortality. Maintaining vascular health within the scope of global risk reduction in a personalized manner will be the cornerstone of modern cardiovascular disease prevention rather than waiting until arterial hypertension develops.