Does rapidity of blood pressure lowering affect outcomes in hypertension treatment?

Hypertension affects more than 65 million Americans and is inadequately controlled in most of them. The presence of uncontrolled hypertension confers increased rates of cardiovascular mortality. The benefits of blood pressure reduction have been clearly demonstrated in many large placebo-controlled trials. Even small differences in blood pressure can reduce the number of major cardiovascular events. Data from the Study on Cognition and Prognosis in the Elderly (SCOPE), Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) study, and Systolic Hypertension in Europe (Syst-Eur) trial demonstrate that the achievement of early blood pressure reduction has long-term benefits on cardiovascular outcomes. VALUE demonstrated that blood pressure control within the first month of treatment was independently linked to cardiovascular outcomes. Similar results were obtained in the SCOPE and Syst-Eur trials when hypertensive therapy was delayed from 3 months to 2 years. The early achievement of blood pressure control should be of paramount importance both for physicians and their patients.