Prevention of hypertension.

This review summarizes papers and reports published during the past year that contribute important knowledge or perspectives about prevention of elevated arterial blood pressure. Emphasis is on controlled intervention trials, particularly the large, multicenter Trials of Hypertension Prevention-Phase I, but all relevant randomized trials known to the author are included. Observational epidemiologic studies that are cross-sectional, eg, the INTERSALT study and the US Pitt County Study, or longitudinal, eg, the large Health Professionals Followup Study and the National Health and Nutrition Examination Survey (I) Epidemiologic Followup Study, are also discussed. The recent evidence, when viewed in the context of the previously accumulated literature, supports the recommendations of two recent expert reports to the effect that 1) much knowledge is available to help avoid the rise of blood pressure with age that is the hallmark of the epidemic of hypertension in industrialized societies, and 2) efforts should be particularly directed toward control of obesity, increased physical activity, reduced salt intake, and moderation of alcohol use.