Maximally reducing cardiovascular risk in the treatment of hypertension

With the increasing recognition of relatively mild hypertension, asymptomatic patients are being started on life-long therapy with antihypertensive agents. Before the diagnosis is made or therapy instituted, elevated blood pressure must be verified. To provide maximal protection against premature cardiovascular disease and coronary disease, various non-drug therapies should be used that lower both blood pressure and other risk factors. Drugs should be chosen to provide maximal efficacy, long-term safety, and multifaceted convenience, providing the greatest protection with the least interference with quality of life. These goals can be best achieved by stubstituting commonly used drugs such as diuretics, central agonists, and beta-blockers with vasodilators, such as alpha-blockers, angiotensin-converting enzyme inhibitors, and calcium blockers.