Risk factors and differential antihypertensive therapies

A less pronounced reduction in the incidence of coronary heart disease than in cerebrovascular events has been observed during antihypertensive therapy. Hypertension may not be the dominant risk factor for coronary heart disease as it is for cerebrovascular disease, and metabolic factors gain more importance. The reason for the differential effect of antihypertensive therapy could partly be explained by the adverse metabolic effects of some antihypertensive drugs which may thus attenuate the beneficial effects. When decision is made concerning antihypertensive treatment, it is imperative to assess the overall cardiovascular risk of the patient and take into account the possible impact on these factors of the different antihypertensive drugs.