[Treatment strategy on hypertensive cardiovascular damage observed in various guidelines]

Since the publication of the Japanese guidelines for the treatment of hypertension in 2000, a lot of large-scale clinical trials on the treatment of hypertension have been reported. Furthermore new guidelines for the treatment of hypertension, such as JNC-VII and ESH-ESC guidelines have been reported in 2003. On the consideration of results of these trials and new guidelines, treatment strategy on hypertensive cardiovascular damage was described in this manuscript. The initiation criteria of drug therapy, modifications of life-style, selection of antihypertensive drugs and target blood pressure are various in each guideline. However, strict control of blood pressure is the most important to protect cardiovascular damages, regardless differences in the treatment strategy in each guideline. In the drug therapy Ca channel blockers, inhibitors of the renin-angiotensin system and diuretics are mainly used as monotherapy or a combination therapy to obtain the target blood pressure.