EVALUATION OF THE RISK OF HYPERTENSION - FROM THE POPULATION TO THE INDIVIDUAL

Epidemiological studies have contributed to our understanding of sever al aspects of hypertension which could not have been remarked upon by clinical medicine alone : 1) the continuous nature of the relationship between the level of hypertension and cardiovascular risk has shown t hat the clinical definition by criteria based on numbers is arbitrary and should be adjusted according to the context and therapeutic manage ment; 2) the risk of high blood pressure is strongly dependent on the presence or absence of other risk factors (smoking, diabetes, serum li pids, left ventricular hypertrophy). a factor which is not sufficientl y taken into account in clinical practice; 3) assessment of the absolu te risk of an individual on the basis of the respective roles of the p rincipal risk factors is a useful guide to treatment. Moreover, popula tion studies have shown that mild increases in blood pressure, associa ted with a long individual risk, are responsible for a large number of cardiovascular events because of the many people affected. Preventive action on the whole population is necessary in addition to individual therapeutic intervention in the clinical setting.