Mortality matters

When treating cardiovascular disorders such as arterial hypertension, the major goal of treatment is to reduce morbidity and mortality. The present review will concentrate on how the treatment of cardiovascular disorders affects mortality. Hypertension studies performed in the 1950s showed that treatment of malignant hypertension improved five year survival dramatically. More recent studies in patients with nonmalignant hypertension have shown positive effects on mortality as well, especially with regard to the treatment of hypertension in the elderly. Other cardiovascular disorders have also been treated successfully with regard to mortality. This is true in particular of postmyocardial infarction patients, in whom beta-blocker treatment has been effective. Moreover, patients with congestive heart failure have been shown to benefit from treatment with angiotensin converting enzyme (ACE) inhibitors as regards total mortality. The most recent addition to our knowledge stems from the GISSI-3 trials in which lisinopril, alone or in combination with nitrates, was shown to reduce mortality in patients with acute myocardial infarction.