Epidemiologic research in hypertension: a critical appraisal

Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the results of this research can only be described as modest. The basic epidemiologic and demographic description of blood pressure distributions in human populations remains problematic and psychosocial studies have not yielded clear and solid hypotheses pointing the way to future research. There is no doubt that blood pressures vary among and between population groups, and there seems little doubt that variations in life-style are associated with these differences. It is puzzling that we have failed to discern systematic and patterned relationships among these variables. It is suggested that a more useful approach to research in this field would be to distinguish factors that affect general susceptibility to becoming ill from those that initiate or maintain particular disease states.