The outcome of STOP-Hypertension-2 in relation to the 1999 WHO/ISH hypertension guidelines

The 1999 hypertension management guidelines issued by the World Health Orga nization and the International Society of Hypertension emphasize the import ance of blood pressure reduction in the prevention of cardiovascular events . Furthermore, they conclude that the benefits of treatment are due to bloo d pressure lowering per sc, rather than to any specific antihypertensive th erapy. The results of the second Swedish Trial in Old Patients with Hyperte nsion (STOP-Hypertension-2) are consistent with these recommendations, sinc e in this trial angiotensin converting enzyme (ACE) inhibitors and calcium antagonists reduced blood pressure to the same extent as conventional thera py with beta-blockers and diuretics in elderly hypertensive patients, and t he three treatments produced similar reductions in the risk of cardiovascul ar events. Furthermore, a first subgroup analysis of cardiovascular mortali ty showed that the three treatments seemed equally effective in diabetic pa tients. The STOP-Hypertension-2 data, therefore, are fully consistent with the 1999 hypertension management guidelines, and underline the advantages o ffered by both older and newer antihypertensive therapies.