[Evidence-based medicine and arterial hypertension: reasonable or unreasonable marriage?]

Rational medical decisions should be based on the best possible evidence. Yet clinical trial results may not reflect conditions in actual practice. In hypertension, for example, the evidence-based approach to medical care involves the explicit use of evidence on the magnitude of the effects of interventions to influence treatment decisions. Evidence-based medicine is a paradigm challenging our medical practice, as foundation it uses proofs originating from scientific research and controlled randomized trials, more than intuition, clinical experience and pathophysiologic rationale. In this article, we analyze two clinical problems in hypertension generating current questions. We try to use this method in order to obtain pertinent answers for a given patient. We observe that the application of EBM has some limitations. Very restrictive inclusion criteria in some studies make the sample of patients studied not comparable with the individuals in front of us. On the other hand, for other sub-groups of patients, results obtained from EBM are very useful and give valuable information. For a good application of this paradigm critical reading of literature is essential, in order to balance its importance.