Article

Atherosclerotic Complications of Hypertensive Disease: Relation to Therapeutic Response and to Serum Protein and to Lipoprotein Concentrations

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Abstract

THE course and prognosis of severe essential hypertension have been profoundly modified, in the past five years, by the effective use of antihypertensive drugs in patients with advancing vascular disease.1 Favorable responses to these agents can be anticipated in a majority. Such responses include lowering of arterial pressure, stabilization or remission of, or, in some patients, actual recovery from manifest cardiac, cerebral, or renal hypertensive vascular disease.2

Although the mechanisms and sites of action of the available antipressor agents are varied, the common denominator of their effectiveness is the lowering of arterial pressure. This is followed by improvement of the obvious aspects of renal or cerebral arteriolosclerosis or of cardiac failure. Such remissions are clinical confirmations of the experimental finding that high blood pressure, per se, is the primary cause of arteriolar damage and cardiac strain. While hypertensive vascular disease is primarily an affliction of the arterioles, its association with arterial disease, namely, atherosclerosis, is also well recognized. The purpose of this report is to describe the beneficial effects of antihypertensive therapy on the survival of patients with advancing vascular disease and to discuss the extent to which atherosclerotic complications are affected by treatment.

Some of the many glowing reports on the use of antihypertensive drugs overlook the axiom that new solutions resolve old problems, but they inevitably create new ones. Unfortunately not all the old problems have been solved, for there still are a few patients in whom blood pressure is not controlled by the present therapeutic regimens; in. . .


 

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