There is clear evidence that in severe hypertension lowering blood
pressure, by drug therapy decreases the incidence of major
cardiovascular events. Recent studies suggest that such benefit may
also extend to patients with mild to moderate hypertension. The
putative benefits of drugs may be offset, however, by their adverse
effects and a prime example is the increased incidence of impotence
and metabolic disorders in patients on thiazide diuretics. There
is, therefore, a real need to look further into the therapy of
patients with mild to moderate hypertension. The ideal drug in such
patients would oppose the basic mechanisms responsible for the
elevation in blood pressure, would prevent counter-regulatory
responses and would have minimal side-effects in both the
short-term and the long-term, the latter being of particular
importance to younger patients. These aspects were considered at
the symposium "Mild hypertension. Current con troversies and new
approaches" held at Titisee in West Germany, October 13-15 in 1983.
The foundation for discussion was set with an exposition of the
neural and hormonal regulation of blood pressure in normal man
followed by a consideration of the possible pathophysiological
mechanisms involved in patients with hypertension. Particular at
tention was focused on the central nervous system and on effects
governed by activity of the peripheral nervous system as these may
well provide further opportunities for logical therapeutic
intervention in clinical hypertension. The current management of
mild to moderate hypertension was then reviewed.
General
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