Current hypertension management: separating fact from fiction

In medicine, as in other fields, myths or speculations may be repeated so often and so widely that they are perceived as fact. To some extent, this may have occurred with regard to the treatment of hypertension, especially concerning the use of diuretics and beta blockers and the significance of their metabolic effects. An analysis of the available data indicates that the use of diuretics and, to some extent, beta-adrenergic inhibitors will effectively lower blood pressure and reduce morbidity and mortality. Similar analyses strongly suggest that the metabolic changes induced by these agents may not be of major clinical importance. The widespread dissemination of theories and speculations designed to convince physicians to avoid their use may have been overdone. Scientific facts, not extrapolations of data, should be used to make treatment decisions.