G. Mancia et G. Grassi, EVIDENCE THAT HAS BEEN OR SHOULD BE CONSIDERED FOR GUIDELINES ON ANTIHYPERTENSIVE TREATMENT, International journal of clinical practice, 1997, pp. 8-12
Guidelines on antihypertensive drug treatment were first issued in the
'70s by the American Joint National Committee and by the World Health
Organization/International Society of Hypertension (WHO/ISH). They ar
e updated periodically to allow for the effective treatment of high bl
ood pressure. This paper will examine the importance of the results of
clinical trials of antihypertensive treatment on hypertension guideli
nes. It will also examine the reasons why case-control and cohort stud
ies should be interpreted with caution when guidelines are issued. Fin
ally, the importance of surrogate endpoints for morbid and fatal event
s - such as the regression of left ventricular hypertrophy or early si
gns of renal damage - will be highlighted.