Therapy for mild hypertension. Toward a more balanced view

Abstract

PUBLICATION in this journal of the results of the Multiple Risk Factor Intervention Trial (MRFIT)¹should bring about a reassessment of the current widespread and routine use of drug treatment for most people with mild hypertension, defined as a diastolic BP between 90 and 104 mm Hg. Such patients make up about 75% of the hypertensive population, a total of at least 30 million Americans. Most American practitioners are now responding to the admonishments of hypertension experts and pharmaceutical advertisements that the "HDFP (Hypertension Detection and Follow-up Program) findings justify early and aggressive management of mild hypertension." Even before the HDFP²or any other data in support of the value of such therapy for mild hypertension were available, 92% of the physicians in New York State who responded to a questionnaire indicated they routinely gave antihypertensive drug therapy to patients with diastolic BPs between 90 and 104 mm