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The explosion of morbidity and mortality trials in hypertension
1Division of Epidemiology and Clinical Applications, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
Insights
Hypertension trials have evolved from determining who to treat to identifying optimal drug treatments and blood pressure targets. Current research focuses on morbidity and mortality to refine hypertension management strategies.
Area of Science:
- Cardiovascular Medicine
- Clinical Trials
- Hypertension Research
Background:
- Hypertension trials have progressed through distinct generations, each with evolving focuses.
- Early trials concentrated on middle-aged and elderly populations, initially targeting diastolic and then systolic blood pressure.
Purpose of the Study:
- To review the historical progression and current trends in hypertension clinical trials.
- To understand the shift in focus from treatment initiation to drug selection and target blood pressure goals.
Main Methods:
- Historical analysis of hypertension trial evolution.
- Review of current morbidity and mortality trials in hypertension.
Main Results:
- Generations of trials have progressively refined treatment criteria.
- Current trials emphasize specific drug therapies and precise blood pressure targets.
Conclusions:
- Understanding the trajectory of hypertension trials is crucial for evidence-based practice.
- Future research aims to optimize patient outcomes through targeted interventions and goal setting.
Abstract:
The highlights of each generation of hypertension trials have been varied, but interrelated. The initial hypertension trials focused on middle-aged hypertensive individuals and later on the elderly, with emphasis on diastolic blood pressure and subsequently on systolic blood pressure. Past generations of trials elucidated whether and whom to treat. The current explosion of morbidity and mortality trials in hypertension largely seeks to learn what drugs should be used and to delineate what blood pressure goals should be targeted.