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JAMA Revisited
June 4, 2014

The Rational Treatment of Arterial Hypertension

JAMA. 2014;311(21):2238. doi:10.1001/jama.2013.279537

Functional and structural abnormalities of the peripheral vascular system, rather than the degree of elevation of the blood pressure, are the significant aspects of “persistent arterial hypertension.” Because of the ease with which the systolic and diastolic arterial pressures can be determined, and because of the lack of clinical or laboratory methods for the evaluation and measurement of the peripheral vascular resistance, the height of the blood pressure has come to be considered the index of this resistance. The terms elevated blood pressure and increased vascular resistance, therefore, are frequently used interchangeably, even though a quantitative relationship between these two factors of the circulation does not always exist. Clinical terms such as hyperpiesia (Clifford Allbutt), hypertonia (Pal) and hypertensive cardiovascular disease (Theodore Janeway) define this clinical state of the cardiovascular system more accurately than the generally accepted terms, arterial hypertension and essential hypertension.

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