Considerations on current and future trials in hypertension.

Conclusive evidence from large-scale epidemiological studies has shown that hypertension is a major risk factor for cardiovascular disease. Large-scale intervention trials have indicated that, by reducing elevated blood pressure values with antihypertensive treatment, the risk can be decreased. Despite the large body of evidence on the protective effects of the blood pressure reduction, several questions concerning the benefit of antihypertensive treatment remain unanswered. This paper briefly reviews the information provided by clinical trials on antihypertensive treatment. It also critically examines the questions that have remained partially or totally unanswered and the trials that are currently addressing them. Focus is directed on the Insight Study which addresses the benefit of antihypertensive treatment in hypertensive subjects with additional cardiovascular risk factors.