Review on Hypertension and Antihypertensive Drugs

Hypertension is a very common and serious condition that can lead to or complicate many health problems. Antihypertensive therapy has been used for almost 45 years to reduce the blood pressure and to prevent morbidity and mortality related to the hypertensive state. Cardiovascular events are related to the initial elevation of blood pressure; the benefits of treating malignant, severe or moderate hypertension are well established. Recently it has emphasized that the absolute risk of cardiovascular events is determined only in part by blood pressure, and that it is also influenced by age, gender, race and presence of cardiovascular risk factors. For example in older individuals where the absolute risk of vascular complication is greater than in younger individuals for any given level of blood pressure. Drug therapy has been shown to be extremely effective in reducing the incidence of stroke, congestive heart failure and renal failure associated with elevated blood pressure. Experimental data suggesting differences in the ability of antihypertensive drugs to inhibit atherosclerosis in animals models are also of interest, but again the relation of the findings to the clinical situation is unknown. Thiazide diuretics, beta blockers, calcium antagonists, Angiotensin Converting Enzyme Inhibitors and Alpha blockers can produce regression of Left Ventricular Hypertrophy. While Left Ventricular Hypertrophy is a clearly a strong and independent predictor for coronary disease, it remains to be shown that a lower risk for coronary morbid events exists in patients whose Left Ventricular Hypertrophy has undergone regression over and above that attribute to blood pressure reduction.