Hypertension: Some Unanswered Questions

The measurement of a patient's blood pressure is a routine procedure when a person visits a physician or health facility. We carry out this test because elevated blood pressure is an etiologic factor for the development of stroke, coronary heart disease, congestive heart failure, and renal failure. In recent years, many different drugs have become available to reduce blood pressure. Normalization of elevated blood pressure decreases the risk of the various complications, and vigorous therapy for hypertension is recommended by many authorities. Since the condition is common, millions of individuals are labeled as hypertensives and many are given antihypertensive drugs to lower their blood pressure. Our current policies raise many questions. While we define hypertension as a blood pressure of more than 160/90 mm Hg or thereabouts, this definition is arbitrary. The distribution of blood pressure in the normal population is continuous, with no "cutoff" pressure at which a person