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October 17, 1990

What Goes Up Must Come Down, But Hypertension Experts Worldwide Differ About Ways, Means

JAMA. 1990;264(15):1920-1925. doi:10.1001/jama.1990.03450150018004

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BLOOD PRESSURE levels that make an American physician write a prescription may elicit only advice about life-style in Switzerland. Most Australians know of the need for medical assessment of individual risk factors for cardiovascular disease, while millions of Brazilians are so unaware of potential health problems that malignant hypertension, which has nearly disappeared in the industrialized world, remains a real threat in that country.

These variations and others emerged in a special panel discussion among experts from seven nations who assembled in Baltimore, Md, for the American Heart Association's (AHA) 44th annual fall conference and scientific sessions of its Council for High Blood Pressure Research. The other countries represented were Britain, Japan, and West Germany.

Although national policy details may not be the same, said Stevo Julius, MD, professor of medicine and physiology, University of Michigan, Ann Arbor, smiling wryly, "one thing is no different. Hypertension is a disease treated