Hypertension is usually symptomless and associated with little or no a
lterations in well-being. However, conclusive evidence demonstrates th
at hypertension is a major risk factor for cardiovascular disease. A r
eduction of the elevated blood pressure with antihypertensive medicati
on can reduce this risk, but not to that of a normotensive patient. Fu
rthermore, antihypertensive treatment is more effective against stroke
and congestive heart failure than against coronary heart disease. Ant
ihypertensive treatment is costly due to its extensive use and life-lo
ng indication. Future progress in this area will aim to identify those
hypertensive patients at greatest risk of cardiovascular disease, in
order to limit treatment to those patients who may benefit most. This
paper will consider the effects of blood pressure reduction on cardiov
ascular morbidity and mortality, the differing effects of antihyperten
sive treatment on the complications of hypertension, and how antihyper
tensive therapy can be optimized.