Drug Therapy of Hypertension

General Considerations The majority of functional alterations resulting from prolonged or severe hypertension stem from damage to three important vascular beds, the brain, the heart, and the kidneys. When hypertension becomes sufficiently severe and/or is sustained for an adequate period of time, this in itself can produce the vascular deterioration that occurs in these areas.¹It is rational to treat patients with severe disease, especially when complications exist which have resulted from the elevation in blood pressure. It also seems rational to treat patients with moderately severe disease. Here the objective is to prevent progression and the development of serious complications. Although the treatment of hypertension is still largely empirical, evidence is accumulating rapidly which indicates that the symptoms and complications resulting from severe and prolonged hypertension can be improved by effective reduction of blood pressure, using currently available antihypertensive agents. It follows naturally that the chief indications for