There has been increasing emphasis in the professional and lay literature on the importance of treating all patients with elevated arterial blood pressures. The physician is being put under considerable pressure to treat; the arena of hypertension is the new focus in preventive cardiology. This emphasis is appropriate, but there remain many problems about therapeutic approaches to hypertension for which we do not have answers.
The level of diastolic blood pressure that merits treatment is an example of the clinician's therapeutic dilemma. In one recent report, the implication is made that hypertension manifested by a single diastolic arterial pressure of 95 mm Hg or higher with the patient in the seated position should be treated (1). But we still do not have objective data to help us decide at what level of "elevated" blood pressure drug treatment should be started. And, assuming that we can agree when to start such
Miller AJ. The Treatment of Hypertension: Therapeutic Fervor and Compliance. Arch Intern Med. 1977;137(11):1597–1598. doi:10.1001/archinte.1977.03630230073018
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