September 23, 1996

Controlling HypertensionA Research Success Story

Author Affiliations

From the Departments of Pharmacology and Medicine, University of Vermont College of Medicine, Burlington (Dr Dustan); National High Blood Pressure Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (Dr Roccella); and Office of Public Affairs, Federation of American Societies for Experimental Biology, Bethesda (Dr Garrison).

Arch Intern Med. 1996;156(17):1926-1935. doi:10.1001/archinte.1996.00440160034007

In the past 2 decades, deaths from stroke have decreased by 59% and deaths from heart attack by 53%. An important component of this dramatic change has been the increased use of antihypertensive drugs. This remarkable success resulted from broad-based and diverse research programs supported by the federal government, pharmaceutical companies, voluntary health agencies, and private foundations. It included basic research, drug development programs, epidemiologic studies, health surveys of US citizens, clinical research, and large-scale drug trials. Four of the categories of antihypertensive drugs in wide use—diuretics, β-blockers, calcium antagonists, and angiotensin-converting enzyme inhibitors—emerged from widely different areas of investigation. In the beginning, the major breakthroughs that led to the development of these drugs were impossible to forecast, and their ultimate applications were impossible to predict. Although decreases in hypertensionrelated mortality are impressive, enthusiasm must be tempered because the mechanisms of hypertension are still incompletely understood and prevention is not yet possible. Continued research is needed to extend these advances.

Arch Intern Med. 1996;156:1926-1935