On combating hypertension: when and how
May, J.F.; ten Berge, B.S.; Donker, A.J.
Netherlands Journal of Medicine 29(11): 342-346
1986
ISSN/ISBN: 0300-2977 PMID: 3808138 Document Number: 272422
Factors of importance in the decision to start antihypertensive treatment are: blood pressure as a risk indicator when judging the composite cardiovascular risk; effects on mortality and morbidity found in intervention studies; the prevalence of high blood pressure; side effects and non-compliance. It still seems to be a reasonable approach to start treatment if after several (e.g. five) measurements on different occasions diastolic blood pressure is above 100 mm Hg or between 95 and 100 mm Hg in the presence of an increased composite risk. This applies to all ages. General prevention of high blood pressure is essential, but difficult to achieve due to the prevention paradox. During therapy optimalization of compliance and quality of life are of primary importance. Active case finding should be considered if the follow-up is guaranteed. The model of the Groningen Hypertension Service may be helpful for optimal treatment implementation, especially in general practice, and in addition, if one considers active case finding, for low-cost population screening.