Hypertension control: Multifactorial contributions

Treatment of hypertension reduces the risk of several associated deleteriou s conditions, although it does not lower risk for all cardiovascular diseas es. A new theory suggests that high blood pressure is but one piece in the puzzle of a complex syndrome of inherited risk factors called the hypertens ion syndrome. Several new findings have emerged theorizing that patients ma y have coronary artery disease before the actual onset of elevated blood pr essure. Epidemiologic studies have found that normotensive patients with a family history of hypertension often have a disease process and prognosis s imilar to that of hypertensives. It seems that some patients may "inherit" abnormalities that make them prone to the development of hypertension, as w ell as a complex series of cardiovascular disease risk factors. These inclu de elevated lipids, increased left ventricular hypertrophy, arterial stiffe ning, insulin resistance, renal function abnormalities, and neuroendocrine changes. It is conceivable that the hypertension syndrome may be reversible if the disease process is diagnosed early, which appears to be well before the actual onset of high blood pressure. High blood pressure may be a risk marker for irreversible vascular disease and early detection of the many c omponents of hypertension syndrome may delay or prevent cardiovascular dise ase from developing in high-risk patients. Am J Hypertens 1999;12:164S-169S (C) 1999 American Journal of Hypertension, Ltd.